Wiki New to Ophthalmology/Optometry Coding

Create Wiki
J

joglesbee

Guest
Messages
53
Best answers
0
I am needing a little help. My office just picked up billing/coding for a Ophthalmologists office and I am having some confusion when it comes to E/M vs the general opthalmological examinations and which CPT codes should be used for which patients.

Is there a general rule of thumb where you file the 99201-99215 or the 92002-92014. This is including new patient and established patient.

Also is there a limit to the number of times you can file the 92002-92014 codes in a year?

If anyone could help me out on this that would be extremely appreciated.
 
joglesbee said:
I am needing a little help. My office just picked up billing/coding for a Ophthalmologists office and I am having some confusion when it comes to E/M vs the general opthalmological examinations and which CPT codes should be used for which patients.

Is there a general rule of thumb where you file the 99201-99215 or the 92002-92014. This is including new patient and established patient.

Also is there a limit to the number of times you can file the 92002-92014 codes in a year?

If anyone could help me out on this that would be extremely appreciated.
Click to expand...

The reason for the patient visit would drive (determine) which code route to follow.
The Eye Codes (92002-92014) are, generally speaking, for routine eye examinations {1 year follow-up, annual exam, etc.} and the E/M for a medical reason {glaucoma, retinal detachment, diabetic exam, etc.}. Just as with E/M, there is the three year rule for new vs. established patient. Also, most carriers limit the number of Eye Codes to 1 per calendar year. You will need to verify with your carriers for their guidelines.

Hopefully this helps some.
David Keown, CPC, OCS
 
Code 92002-92014 is it OK to code by Optometrist or it is only for Opthomologist
what is the link to check the coding guidelines for Optrometrist

Thank you
 
kumeena said:
Code 92002-92014 is it OK to code by Optometrist or it is only for Opthomologist
what is the link to check the coding guidelines for Optrometrist

Thank you
Click to expand...

The CPT does not distinguish between Optometrist and Ophthalmologist; both are physicians and are permitted to use the code most appropriate for the reason the patient is being seen.

Hope this helps!
David Keown, CPC, OCS
 
You must log in or register to reply here.
Top