Coding News and Expert Advice

Coding News and Expert Advice
Empower your coding team with the up-to-date answers from the Academy's coding experts. Our carefully researched responses cover federal and commercial payers and help you improve documentation, submit clean claims and appropriately maximize reimbursement. Not a AAOE member? Join today.
Note: Coding regulations and edits can change several times a year. All Academy coding advice is based on most current information available at the time of publication. When in doubt, visit aao.org/coding for the most recent updates. Information provided by our coding experts is copyrighted by the American Academy of Ophthalmology and intended for individual practice use only.
1-20 of 762 results
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Coding Top 10: Payment for Intra-operative Injection , Practice Telemedicine Protocol, Billing Consultation Codes When Medicare is Secondary

MAY 13, 2021 in Coding Top 10, ICD-10, Ask the Expert, Coding Updates

Get trusted answers to your coding questions from the Academy's coding experts, so you can bill and code with confidence.

Comments 0

Views 83

CAAP Recoupment on Medicare Claims

MAY 13, 2021 in Regulatory News

Ophthalmic practices who received a COVID Accelerated/Advance Payments (CAAP) from CMS will start to see a new physician adjustment amount on their remittance advice.

Comments 0

Views 26

Documentation Rules for Physicians and Non-Physician Practitioners

MAY 13, 2021 in Exams, Ask the Expert

I’ve read that an ophthalmologist does not have to redocument information in the chart note, but does that also apply to our physician assistant (PA)?

Comments 0

Views 17

External Surgeon Using Laser

MAY 13, 2021 in Ask the Expert, Glaucoma

A physician outside of our practice asked to use our laser to perform selective laser trabeculoplasty (SLT) on her patients. Although we have reached out to our malpractice carrier for potential concerns, are there billing issues that need addressed?

Comments 0

Views 10

Billing Corneal Hysteresis More Than Once

MAY 13, 2021 in Glaucoma, Ask the Expert, Testing Services

Can corneal hysteresis be billed again after an intervention such as an SLT or starting new medication?

Comments 0

Views 9

Billing Consultation Codes When Medicare is Secondary

MAY 13, 2021 in E/M, Ask the Expert

The primary insurance is a commercial plan that recognizes consultation codes. Medicare Part B is the secondary insurance. Can we bill a consult code?

Comments 0

Views 5

Billing Eye Visit Codes to Commercial Payers

MAY 13, 2021 in Ask the Expert, E/M

Medicare accepted eye visit code with medical diagnosis, but the commercial plan as secondary insurance, denied the claims. How do I proceed?

Comments 0

Views 15

Billing Tests for Inpatient Exams

MAY 13, 2021 in Ask the Expert, Testing Services

If I see inpatients (hospital or emergency department) and bring in my own portable B-Scan or handheld camera, do I submit 92250 or 76512?

Comments 0

Views 4

Patient Status When Billing Different Payers

MAY 13, 2021 in Ask the Expert, Exams

Does the routine vision exam reset the new patient clock so today’s medical exam can be billed as a new patient exam?

Comments 0

Views 5

Practice Telemedicine Protocol

MAY 13, 2021 in Ask the Expert, E/M, Telemedicine

An evaluation of telemedicine protocol

Comments 0

Views 6

Diagnosis Selection When Multiple Cataracts

MAY 13, 2021 in Ask the Expert, Cataract/Anterior Segment

The surgeon’s documentation lists mature/posterior subcapsular cataract (PSC) for the cataract. How would you recommend coding this? As a mature cataract or a PSC?

Comments 0

Views 9

Payment for Intra-operative Injection

MAY 13, 2021 in Cataract/Anterior Segment, Ask the Expert

Can a surgeon be paid separately when administering a retrobulbar block prior to cataract surgery?

Comments 0

Views 7

Stay Current with Payer Policies

APR 29, 2021 in Ask the Expert, Regulatory News

While any service you perform the most may be an audit target, you are most likely to be audited on something that has a published policy. Research each payer to see what they require and ensure your documentation exceeds expectations.

Comments 0

Views 126

Corneal Laceration - Coding for Ocular Trauma case study

APR 20, 2021 in Trauma Coding, ICD-10, Exams, Ask the Expert, CPT, E/M

First day on the job at a home improvement store, an 18-year-old cuts the metal band around layers of stacked wood. The metal band flipped lacerating his cheek to forehead, including eye on the left side of his face.

Comments 0

Views 98

Canalicular Laceration - Coding for Ocular Trauma case study

APR 20, 2021 in Exams, Trauma Coding, CPT, ICD-10, E/M, Ask the Expert

Exam revealed right lower canalicular laceration from wire hidden in lawn.

Comments 0

Views 62

Commotio Retina Involving Macula - Coding for Ocular Trauma case study

APR 20, 2021 in Ask the Expert, CPT, E/M, ICD-10, Trauma Coding, Exams

8-year-old nephew of retina specialist was hit in left eye with soccer ball. Immediately complained of decreased vision.

Comments 0

Views 43

Coding for Phone Calls, Internet and Telehealth Consultations

APR 16, 2021 in Coding Updates, Regulatory News, Telemedicine

There are new coding guidelines for ophthalmic practices that want to bill for telehealth and other communications-based technology services.

Comments 0

Views 185914

What to Do When Receiving a Comparative Billing Report from Any Payer

APR 13, 2021 in Ask the Expert, Regulatory News

Q: What do I do when I receive a comparative billing report?

Comments 0

Views 940

Coding Top 10: Moderate Decision Making for Medically Necessary Surgery, Billing Telemedicine Emergency Exam and Follow-up, Billing Injectables to Skilled Nursing Facility

MAR 17, 2021 in Coding Top 10, Coding Updates, Ask the Expert, ICD-10

Get trusted answers to your coding questions from the Academy's coding experts, so you can bill and code with confidence.

Comments 0

Views 1111

Billing Injectables to Skilled Nursing Facility

MAR 05, 2021 in Coding Competency, Ask the Expert, Retina

Q: Since Medicare states it will not reimburse for injected drugs while the patient is in a skilled nursing facility (SNF), do we bill the full amount to the facility?

Comments 0

Views 68

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