Wiki 99201 & 99202 New Codes

[foerster]

Has anyone experienced Medicare denials for the new Ophthalmology codes 99201 & 99202?
We have submitted with and without the XU modifier and the code is still denied.
Any thoughts?

 

[vanessamoldovan]

Has anyone experienced Medicare denials for the new Ophthalmology codes 99201 & 99202?
We have submitted with and without the XU modifier and the code is still denied.
Any thoughts?

I'm sure you are referring to 92002-92004, correct? Can you please share the specific denial? Vanessa

 

[foerster]

No, there are 2 new codes for the ophthalmoscopy 99201 - retina issues & 99202 - optic nerve/ macula issues.

 

[vanessamoldovan]

No, there are 2 new codes for the ophthalmoscopy 99201 - retina issues & 99202 - optic nerve/ macula issues.

see attached descriptions for 99201 and 99202.

 

[mitchellde]

You must have incorrectly read or written down something 99201 and 99202 are new patient office visit codes and are not new CPT codes. Where are you getting your information? Did you look in the code book?

 

[foerster]

LOL...yes the codes are 92201 & 92202...sorry for all the confusion.
So, does anyone have any information on these 2 codes..... Thanks

 

[bwilcox6917@gmail.com]

If I want to report 92201 bilaterally should I add the 50 modifier?

 

[vanessamoldovan]

If I want to report 92201 bilaterally should I add the 50 modifier?

Modifier 50 is listed as allowed with this CPT code.

 

[bwilcox6917@gmail.com]

Modifier 50 is listed as allowed with this CPT code.

Can this code be billed with 92250 on the same day? If so would you report it as 92202 -50, 59?

 

[scutler]

I would like to know if the 92250 can be reported together on the same date of service with the 92201? if so can I use modifier 59?

 

[vanessamoldovan]

I would like to know if the 92250 can be reported together on the same date of service with the 92201? if so can I use modifier 59?

92201

MEDIUM

CCI edit: This procedure code can never be reported together with code 92250 due to CCI column 2 code edit

 

[foerster]

Modifier 50 is listed as allowed with this CPT code.

It is my understanding that CPT 92201 & 92202 are unilateral and/or bilateral, which means no modifier 50. It can only be reported once.

 

[foerster]

Can this code be billed with 92250 on the same day? If so would you report it as 92202 -50, 59?

It would appear that a modifier cannot be added. 92250 is bundled with both 92201 & 92202. I am getting denials from Medicare. Is anyone else?

 

[pantaz]

I'm not getting denials from Medicare, however we are seeing a lot of denials from Medicare advantage plans, they are paying 92202 and bundling 92250 to it. I would think that is backwards? Any thoughts?