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E/M Codes vs. Eye Codes

  1. Default E/M Codes vs. Eye Codes
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    Is there a specific difference in documentation requirements when using Eye Codes vs. E/M Codes? What are the specific requirements when choosing an Ophthalmology service code? I am referring to the Ophthalmological codes: 92002, 92004 and 92012, 92014. The descriptions just seem very vague. Please help

    Thanks.

  2. #2
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    The rule of thumb we follow is for stable medical conditions such as; cataract/glaucoma, etc. we code based on E/M guide lines.

    For routine, new conditions, or existing condition complicated w/a new dx, etc we code using the appropriate ophthalmology code.

    Hope this helps

  3. Smile
    I suggest looking into your Medicare LCD's (Local Carrier Determinations) on these codes. They are very helpful.

  4. #4
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    Quote Originally Posted by khoyt View Post
    Is there a specific difference in documentation requirements when using Eye Codes vs. E/M Codes? What are the specific requirements when choosing an Ophthalmology service code? I am referring to the Ophthalmological codes: 92002, 92004 and 92012, 92014. The descriptions just seem very vague. Please help

    Thanks.
    I have asked this question many times and have gotten the run around with answers, i can never get a straight one. But i attended an E/M vs Eye Exam codes seminar and spoke with the speaker one on one afterwards. You can use either codes. If you use E/M you must follow those guidelines meaning you need History, PE and MDM. The PE however is based on the speciality exam. I'm reffering to the 1997 guidelines. If you use the eye exam codes there are no specific guidelines. You would use the same specialty exam and if all bullets are done you bill a comp exam 92004-92014 if not then you bill 92002-92012. Now this could be wrong but i was told this is how you code ophthalmology. Here is the eye exam. Hope this helps, and again if i am wrong can someone please reffer me to the right direction http://www.emuniversity.com/PDF/Specialty_Exam_Eyes.pdf

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