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Opthamology Heading

  1. #11
    Medical Coding Books
    Since I am a member of the AAO-E I ask questions there but it would be great for me to ask all of my questions or answer questions from all the specialities I cover. Lets start this sucker up

  2. #12
    I want a second opinion on this senario. A patient has an Aqueous Shunt surgery (66180) and is seen in clinic for post op visit. On po visit 3 the doctors finds the tube to be misplaced and advises the patient to follow up in clinc the next day. On that day they doctor decides to perform out patient surgery on the patient the following day. I coded this senario as followed

    92014-24 dx 996.59
    92014-24-57 dx 996.59

    The surgery was coded using a -78. I was asked why did i attach a -24 to the visit and why did i attach both the the second. My reply was that the first visit was a complication to surgery, new problem with add work up. The second visit was to recheck and perform the add work up and on that day the decision for surgery was made. It is my understanding that both modifier's are needed to clarify the reason for the visit. She questioned why would that be an unrealted E/M visit during post op but the procedure would require a -78. Related surgery ?? Would anyone agree this was coded correct and i should be able to bill for both visits ?? I understand the patient was in post op but i should be able to bill any complications to surgery along with a -24.

  3. #13
    ^^^ In this scenerio I believe it would be included in the reimb. for the procedure thus an exam should not be charged. I do agree operating again on it would be a -78.

  4. #14
    There is another post going on about billing complication visit's after surgery. According to CMS guidelines all complication's following surgery are included in the original procedure. You can only bill an E/M if a patient had to return to the OR so that is where i am debating this senario. Services Not Included in the Global Surgical Package - Treatment for postoperative complications which requires a return trip to the operating room (OR). An OR for this purpose is defined as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient’s room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient’s condition was so critical there would be insufficient time for transportation to an OR); So in my understanding i should be able to bill those visit's or at least the one before surgery since it determined at that visit to return the patient to the OR. I was just wondering that other's would say about this situation.

  5. #15
    I admit this sounds tricky but to me I would advise my physicians that we should not charge for the exam code for numerous reasons but the most important being why was the tube misplaced?

    Did you use a 66185 for revision on the return to the OR? If so I believe the exam code should be included in the revision.

    Hope this helps.

  6. #16
    I only code the clinic charges, our surgery coder does the actual surgery. Thanks for your help... but i do agree we need a heading also !!

  7. #17
    Minot ND
    Default Me too, help!
    I too code ophthalmology, surgical and clinical. I find that many times I have to direct my questions to the AAO websites. I have contacted the AAPC to request specialty coding for ophthalmology. The more people who ask the better I'm sure.

  8. #18
    Default Diagnosis help !!
    What is the code for esgon ?

  9. Default
    Quote Originally Posted by cpccoder2008 View Post
    I already have that website but they wanted credit card information and you have to subscribe to it. I like the free stuff !! hehe !! Plus, my supervisor wouldn't approve a forum subscibtion just for me. We are a multi specialty group. Thanks anyways ... anyone else know of some forum that are free ?
    I subscribed to it myself and did not have to submit any credit card information. It was free for 6 months...choose that option.

  10. Default
    Quote Originally Posted by ValerieR View Post
    I too code ophthalmology, surgical and clinical. I find that many times I have to direct my questions to the AAO websites. I have contacted the AAPC to request specialty coding for ophthalmology. The more people who ask the better I'm sure.
    We have a ophthalmology subforum NOW. All the previous posts about ophthalmology have been moved here too.

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