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.
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Cataract Documentation Checklist

OCT 13, 2021 in Regulatory News, Cataract/Anterior Segment

In this short video, Ravi Goel, MD presents a cataract surgery documentation checklist to prepare practices for Medicare's Target, Probe and Educate (TPE) audits.

Comments 0

Views 53

Where can I find the physician’s allowable for 83516 and 86891?

OCT 04, 2021 in Ask the Expert, Testing Services

Where can I find the physician’s allowable for 83516 and 86891?

Comments 0

Views 41

How do Medically Unlikely Edits (MUE) impact lab tests for dry eye disease?

OCT 04, 2021 in Ask the Expert, Testing Services

How do Medically Unlikely Edits (MUE) impact lab tests for dry eye disease?

Comments 0

Views 27

Of the published three category III codes, 0207T, 0330T and 0563T for treating MGD, are all billable per eye?

OCT 04, 2021 in Testing Services, Ask the Expert

Of the published three category III codes, 0207T, 0330T and 0563T for treating MGD, are all billable per eye?

Comments 0

Views 38

If the physician manually squeezes the patient’s lids, is there a separate CPT code to submit?

OCT 04, 2021 in Ask the Expert, Exams, Testing Services

If the physician manually squeezes the patient’s lids, is there a separate CPT code to submit.?

Comments 0

Views 36

When we perform any category III or miscellaneous code when diagnosing and/or treating MGD or DED, do we need a modifier on the exam performed the same day?

OCT 04, 2021 in Exams, Testing Services, Ask the Expert

When we perform any category III or miscellaneous code when diagnosing and/or treating MGD or DED, do we need a modifier on the exam performed the same day?

Comments 0

Views 10

Coding Top 10 - September 2021

SEP 22, 2021 in Retina, Oculofacial, Testing Services, ICD-10, Cataract/Anterior Segment, Exams, Glaucoma, Coding Top 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 536

One of our doctors is stating that we can charge the patient for the optiwave refractive analysis (ORA) when the ultrasound, CPT code 92136 isn’t done. Is this true?

SEP 22, 2021 in Cataract/Anterior Segment, Ask the Expert, Testing Services

One of our doctors is stating that we can charge the patient for the optiwave refractive analysis (ORA) when the ultrasound, CPT code 92136 isn’t done. Is this true?

Comments 0

Views 67

Confusion when finding the appropriate diagnosis code for reimbursement for CPT code 66982 Complex cataract extraction with IOL.

SEP 22, 2021 in Cataract/Anterior Segment, Ask the Expert

Confusion when finding the appropriate diagnosis code for reimbursement for CPT code 66982 Complex cataract extraction with IOL.

Comments 0

Views 114

When it comes to submitting billing, should I code the pars plana vitrectomy (PPV) first then 66982 Complex cataract extraction? In the case of the exchange PPV first then 66986?

SEP 22, 2021 in Cataract/Anterior Segment, Retina, Ask the Expert

When it comes to submitting billing, should I code the pars plana vitrectomy (PPV) first then 66982 Complex cataract extraction? In the case of the exchange PPV first then 66986?

Comments 0

Views 55

What is the CPT code for the removal of an anterior chamber implant?

SEP 22, 2021 in Glaucoma, Ask the Expert, Cataract/Anterior Segment

What is the CPT code for the removal of an anterior chamber implant?

Comments 0

Views 42

I am performing iris synechiolysis of adhesions during a cataract surgery. How should the claim be submitted?

SEP 22, 2021 in Cataract/Anterior Segment, Glaucoma, Ask the Expert

I am performing iris synechiolysis of adhesions during a cataract surgery. How should the claim be submitted?

Comments 0

Views 65

Was this the correct use of 67108?

SEP 22, 2021 in Ask the Expert, Retina

Was this the correct use of 67108?

Comments 0

Views 47

How would you bill for tissue plasminogen activator (tPA) injection during the global period of a hyphema in the anterior chamber?

SEP 22, 2021 in Ask the Expert, Glaucoma

How would you bill for tissue plasminogen activator (tPA) injection during the global period of a hyphema in the anterior chamber which can happen after any surgery but particularly following a tube or shunt?

Comments 0

Views 11

Please clarify the current bundling policy or if these codes can be billed as separate procedures? Do we use 67903 or 67904 Ptosis and 15823 Blepharoplasty?

SEP 22, 2021 in Oculofacial, Ask the Expert

Please clarify the current bundling policy or if these codes can be billed as separate procedures? Do we use 67903 or 67904 Ptosis and 15823 Blepharoplasty?

Comments 0

Views 51

Do we charge for lidocaine and dehydrated alcohol also when charging for CPT code 67505 Retrobulbar injection; alcohol?

SEP 22, 2021 in Ask the Expert, Retina

Do we charge for lidocaine and dehydrated alcohol also when charging for CPT code 67505 Retrobulbar injection; alcohol?

Comments 0

Views 20

Payer denying our claim because they paid claim from another specialist for the same date of service. Should we be paid too?

SEP 22, 2021 in Exams, Ask the Expert

Payor denying our claim because they paid claim from another specialist for the same date of service. Should we be paid too?

Comments 0

Views 57

Unbundling 92250 with 92133 or 92134

SEP 09, 2021 in Testing Services, Glaucoma, Retina, Ask the Expert

Our practice received an audit request for 10 records. They are all times when we’ve unbundled CPT code 92133 Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve or 92134 retina from 922…

Comments 0

Views 476

We fit keratoconus lenses and are questioning coverage. Does Medicare cover the actual lenses?

SEP 08, 2021 in Testing Services, Ask the Expert

We fit keratoconus lenses and are questioning coverage. Does Medicare cover the actual lenses?

Comments 0

Views 53

Due to a dense cataract, the IOL measurement was taken on CPT codes 92136 and then 76519. Can I bill both tests?

SEP 08, 2021 in Ask the Expert, Testing Services, Cataract/Anterior Segment

Due to a dense cataract, the IOL measurement was taken on CPT codes 92136 and then 76519. Can I bill both tests?

Comments 0

Views 85

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