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New to Ophthalmology/Optometry Coding

  1. Default New to Ophthalmology/Optometry Coding
    Medical Coding Books
    I am needing a little help. My office just picked up billing/coding for a Ophthalmologists office and I am having some confusion when it comes to E/M vs the general opthalmological examinations and which CPT codes should be used for which patients.

    Is there a general rule of thumb where you file the 99201-99215 or the 92002-92014. This is including new patient and established patient.

    Also is there a limit to the number of times you can file the 92002-92014 codes in a year?

    If anyone could help me out on this that would be extremely appreciated.

  2. #2
    Location
    Lexington Kentucky Chapter
    Posts
    105
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    Quote Originally Posted by joglesbee View Post
    I am needing a little help. My office just picked up billing/coding for a Ophthalmologists office and I am having some confusion when it comes to E/M vs the general opthalmological examinations and which CPT codes should be used for which patients.

    Is there a general rule of thumb where you file the 99201-99215 or the 92002-92014. This is including new patient and established patient.

    Also is there a limit to the number of times you can file the 92002-92014 codes in a year?

    If anyone could help me out on this that would be extremely appreciated.
    The reason for the patient visit would drive (determine) which code route to follow.
    The Eye Codes (92002-92014) are, generally speaking, for routine eye examinations {1 year follow-up, annual exam, etc.} and the E/M for a medical reason {glaucoma, retinal detachment, diabetic exam, etc.}. Just as with E/M, there is the three year rule for new vs. established patient. Also, most carriers limit the number of Eye Codes to 1 per calendar year. You will need to verify with your carriers for their guidelines.

    Hopefully this helps some.
    David Keown, CPC, OCS

  3. Default
    This is what I thought, but I wanted to be sure of that before I started coding.

  4. #4
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    Code 92002-92014 is it OK to code by Optometrist or it is only for Opthomologist
    what is the link to check the coding guidelines for Optrometrist

    Thank you

  5. #5
    Location
    Lexington Kentucky Chapter
    Posts
    105
    Default
    Quote Originally Posted by kumeena View Post
    Code 92002-92014 is it OK to code by Optometrist or it is only for Opthomologist
    what is the link to check the coding guidelines for Optrometrist

    Thank you
    The CPT does not distinguish between Optometrist and Ophthalmologist; both are physicians and are permitted to use the code most appropriate for the reason the patient is being seen.

    Hope this helps!
    David Keown, CPC, OCS

  6. #6
    Default
    Thank you

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