Wiki Opthalmology Question

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nrodrig

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Dr is billing for 92135- Scanning computerized ophthalmic diagnostic imaging
is performing both technical and professional component (global). However, this Dr is billing the technical portion as one date of service service (date service was performed) and billing for the the professional component as another date of service ( day she actually read the scan). I think this is incorrect, I think she is to only bill 92135- global. I need some feed back. Thank you.
 
you are correct. In my book that I have from the American Academy of Ophthalmology "Ophthalmic Coding Coach" It says under description for 92135-Scanning computerized ophthalmic diagnostic imaging with interpretation and report, unilateral. We Bill 92135 RT and 92135 LT. Hope this helps.

Jessica Companey, CPC
 
I disagree with the others. You are asking about the TC and 26 not the LT and RT, correct? The doctors I bill for also billed the same way. They billed the TC and 26 on separate days. The problem we ran into is that when you have a patient that has the same test repeated and the doctor reads them on the same day you get duplicate denials. We had to go back to billing them on the same date of service. The doctor actually does read it on the same day but usually doesn't sign off until a later date. Hope that helps
 
nrodrig said:
Dr is billing for 92135- Scanning computerized ophthalmic diagnostic imaging
is performing both technical and professional component (global). However, this Dr is billing the technical portion as one date of service service (date service was performed) and billing for the the professional component as another date of service ( day she actually read the scan). I think this is incorrect, I think she is to only bill 92135- global. I need some feed back. Thank you.
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I know you posted this over a year ago but here is my answer just in case you're still interested.

It all depends on the place of service. If your providers are "office" based, you bill the OCT (92135) globally per eye (both TC & 26 modifiers but you don't list those - only RT or LT). If you are Hospital based providers, the physician bills the interpretation (26 modifier) on the day the test is actually interpreted. The hospital bills the technical (TC) on the day the test is performed. Hopefully the interpretation is done timely enough for it to have been used for the patient's treatment plan (otherwise the test was not medically necessary).
 
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