Results 1 to 3 of 3

Deb Drew CPC

  1. Default Deb Drew CPC
    Medical Coding Books
    Hello, I code for an ophthalmologist & he was inquiring about a Medicare coding rule that stated that when a physician is seeing a Medicare pt for a general yearly eye exam that is requiring a script for glasses that the ophthalmologist has to charge for an ophthalmic exam ( New pt 92002 & 92004 or Est pt 92012 & 92014 ) with 25 modifier & bill for the refraction ( 92015 ). I have been searching for this rule & can't find anything. Can someone please help me? Thanks!

  2. Default

    I'm not sure who your carrier is, but mine is WPS Part B. In their website, they've got a policy and a companion article. I've included links to both of those.

    Hope this helps!


  3. #3

    I also work for an ophthalmologist. A "routine eye exam" (a refraction) is on the list of Exclusions, meaning not a Medicare benefit. You can find this service alongside other "exclusions", such as hearing aids. If you bill it to Medicare, it's only for the denial. Also, since it is an "exclusion", an ABN is not required. The patient is responsible for this service if it is done.

    Hope this helps!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

Similar Threads

  1. Deb Aikey--Billing Supervisor/coder
    By DAIKEY in forum Billing/Reimbursement
    Replies: 0
    Last Post: 07-15-2013, 09:42 AM
  2. Deb Hughes
    By Hughes1 in forum Orthopaedics
    Replies: 4
    Last Post: 06-30-2011, 12:44 PM
  3. Sesamoidectomy / deb
    By sledson in forum Podiatry
    Replies: 0
    Last Post: 11-02-2010, 12:58 PM
  4. Will Deb Grider do workshop?
    By efuhrmann in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 07-12-2010, 02:41 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.