Plaw4444

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It was brought to my attention that medical evaluation and management CPT Codes (9920* - 9921*) reported by our Optometrists and Ophthalmologists could be rejected by CMS when billed in a SNF-Skilled Nursing Facility-setting (POS 31, 32, etc.).

I have read conflicting info indicating Optometry can bill for either a Medical Exam performed, or the 92*** for Routine (based on high-risk category or cataract SX w/IOL). Now, some of my reading does indicate the 92*** being used for both E&M type services... however that is not how we have handled our routine vs. medical.

1) Are there any carve-outs or rules as to an optometrist providing services within a SNF setting: 2) Can we bill with the correct POS code (31 or 32) and a CPT Code (992**) if medical?

Please don't pass this one by and give this one a look, okay?:rolleyes:
 
I have clients who use both the 99 E&M codes and the following codes for Assisted Living/SNF care. 99325-99327, 99335-99337. They are not having problems being paid by Medicare and other carriers.

Tom Cheezum, OD, CPC, COPC
 
I have clients who use both the 99 E&M codes and the following codes for Assisted Living/SNF care. 99325-99327, 99335-99337. They are not having problems being paid by Medicare and other carriers.

Tom Cheezum, OD, CPC, COPC
Much appreciated, Tom. Have a Blessed day. :)
 
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