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Thread: E/M Coding vs. Ophthalmology Coding

  1. #1

    Default E/M Coding vs. Ophthalmology Coding

    AAPC: Back to School
    Now that consultations are gone for Medicare, we are having a hard time billing out high level exams in our ophthalmology practice. There are two specific eye codes that we use most of the time- 92012 and 92014. However, our glaucoma specialists and retina specialists often do high(er) level exams that require complex medical decision making and are often times decisions for surgery. Where it gets sticky is that a high level E/M code requires 9 "bullets" for eyes. The problem we are having is finding out what they are looking for in those bullets, and if we can bill for the higher level exam like a 99215. Any information would be GREATLY appreciate!

  2. #2
    Join Date
    Apr 2007
    Greensboro, NC


    I am doing a chart review on E&M codes for an ophthalmology practice right now, I am using the 97 guidelines for an eye exam which lists all of the bullets. Send me an email address and I will email these to you. My question is "3 of the bullets, are exams with a slit lamp", if the physician uses a penlight instead of a slit lamp, can I still count those bullets.
    My email is crobinson@dmj.com, if you would like to respond to me regarding this. Any help you can give me would be appreciated.

  3. #3
    Join Date
    Apr 2007

    Default Hmm!! An additional E&M

    Im interested to know why you would need to code two seperate E&M's for Opth. when the CPT code is inclusive of an E&M.

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