Wiki Elements of an eye exam

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cpccoder2008

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I have a copy of the exam and which bullets must be met in order to bill for comp exam what i am not sure of is how to read the exam layout.I found this link which was very helpful but doesn't list all the bullets http://www.uic.edu/com/ophres/readnotes.htm If i were to upload our new progress not would someone be able to tell us what is missing in order to reach a comp exam ?

Thanks
 
cpccoder2008 said:
I have a copy of the exam and which bullets must be met in order to bill for comp exam what i am not sure of is how to read the exam layout.I found this link which was very helpful but doesn't list all the bullets http://www.uic.edu/com/ophres/readnotes.htm If i were to upload our new progress not would someone be able to tell us what is missing in order to reach a comp exam ?

Thanks
Click to expand...

You need to bill whatever the appropriate level code is for the problem, according to what is medically necessary for that problem/chief complaint, other ongoing issues, status of those issues, who is following those issues, etc.

You can do a comprehensive exam whenever you want BUT that does not mean you can BILL for it whenever you want. A patient with conjunctivitis is going to be a low level vs a one eyed patient with 60 IOP.

The final level is made up of history, exam and medical decision (complexity) so a comprehensive exam by itself is not the only thing to consider and, please do not do a comprehensive exam if the only reason is to bill a higher level. Remember, it is all driven by what is medically necessary. THAT is the overarching criterion.

Were you referring to the eye codes and not E/M codes by any chance?
There are certain secret parameter for those.

Good luck!
 
Eye exam

Yes i was reffering to eye exam. We don't bill E/M levels for our eye doctor's by their choice. I was mostly reffering to a blank comp exam form. Something i could show the doctors. I think our templete includes all 12 bullets for a comp eye exam but i wasn't sure about the last two bullets through the dilated pupils. I don't like the way our templete is set up. It's not so coder friendly :D If you didn't know what you were looking for you would be lost. Like on our templete it states :

SLE: LLL: OD__ OS__
S/C: OD__OS__
K: OD__OS__

I was mostly reffering to the abbreviations. Like for the K, why on earth would a K stand for Cornea ?? :confused:
 
You confuse me when you mix Eye exam and bullets.

Bullets are part of the E/M codes. That's how you code the exam portion - by counting bullets (like you would count beans). There is a specific number of bullets assigned to each level of exam.

The Eye codes 92002, 92004, 92012 and 92014 do not have bullets although they do have their own criteria.

K is the standard abbreviation for curvature, which has to do with the cornea and it is measured with a Keratometer.

I can't argue about why they use K as the abbrev for cornea. It's just the way it is.
 
cpccoder2008 said:
I am reffering to eye exam bullets http://www.emuniversity.com/PDF/Specialty_Exam_Eyes.pdf For eye exam codes you have either intermediate exam or comp exam, what documentation do you need for a comp exam ?? What services do you need to perform ?? According to articles i have read if you perform all bullets in the eye exam then it's comp if you perform less then it's intermediate.
Click to expand...

OK. As your link's name says EMUniversity. That stands for Evaluation and Management. Those are the single system exam bullets/documentation requirements for E/M (Evaluation and Management) codes, not for the Eye Exam codes. Evaluation and Management codes can be done by single system criteria or multi system. You can use 1995 guidelines or you can use 1997 guidelines. It's really very involved.

If you want to know the Eye Codes' guidelines/criteria, go to your CPT book and check the introduction to the eye codes, which explains what needs to be included for intermediate and/or comprehensive exams, new or established.
 
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