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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1-20 of 725 results

Check-in with EHR and Practice Management Vendors on 2021 E/M Transition

OCT 21, 2020 in E/M, Ask the Expert

In January 2021, the most significant revisions to the guidelines for evaluation and management (E/M) codes since 1997 will be implemented. These changes will impact your electronic health record (EHR) and practice management (PM) systems, and identifying the implementation…

Comments 0

Views 46

Get ready for new E/M requirements on Jan. 1

OCT 21, 2020 in Ask the Expert, E/M

What’s the first thing we need to do to transition to the new E/M requirements starting Jan. 1?

Comments 0

Views 62

Coding for Phone Calls, Internet and Telehealth Consultations

OCT 20, 2020 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 165902

Academy Series of Free Webinars on Payments and Reimbursements

OCT 09, 2020 in Testing Services, Coding Updates, Coding Competency, Retina

Register today for two LIVE Zoom webinars on Dec. 8 for the CMS Final Fee Schedule rule and on Dec. 15 for the 2021 MIPS Reporting.

Comments 0

Views 249

Coding Top 10: Injection Same Day as Cataract Surgery, Glaucoma Drainage Device, Billing Exam for Separate Complaint Implant After Failed TCP

SEP 22, 2020 in ICD-10, Coding Top 10, Coding Updates, Ask the Expert

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

Comments 0

Views 836

Injection Same Day as Cataract Surgery

SEP 20, 2020 in Retina, ICD-10, Ask the Expert

Can CPT code 67028 Intravitreal injection for diabetic retinopathy be billed for the same eye during cataract surgery?

Comments 0

Views 201

Appropriate ICD-10 code for anterior corneal dystrophy

SEP 20, 2020 in ICD-10, Ask the Expert, Cornea

Which ICD-10 diagnosis code is appropriate for anterior corneal dystrophy?

Comments 0

Views 248

ICD-10 code for headaches not based examination

SEP 20, 2020 in Ask the Expert, ICD-10, Coding Competency

We have a patient who complains of headaches; however, the physician is not classifying it as a migraine based on examination. What ICD-10 code should we use?

Comments 0

Views 205

Glaucoma Drainage Device Implant After Failed TCP

SEP 20, 2020 in ICD-10, Glaucoma, Ask the Expert

I’m performing an Ahmed tube implantation with patch graft within the global period of a failed transscleral cyclophotocoagulation. What CPT code and modifier is appropriate?

Comments 0

Views 83

ABN Usage for Dual-Eligible Patients

SEP 20, 2020 in ICD-10, Ask the Expert, Coding Competency

We have a patient who qualifies for Qualified Medicare Beneficiary (QMB). Are we able to use an Advance Beneficiary Notice (ABN) for a lesion removal?

Comments 0

Views 71

Applicable diagnosis code for rejection to corneal transplant

SEP 20, 2020 in Ask the Expert, ICD-10, Cornea

Our physician states the patient’s diagnosis is rejection to corneal transplant. Is there an applicable diagnosis code?

Comments 0

Views 56

Billing Multiple Retina Testing Services Same Day

SEP 10, 2020 in Coding Competency, Coding Updates, Testing Services, Retina

Although medical necessity may require multiple tests in a session, billing may not allow for all to be submitted. Always confirm if there is a bundling edit in place by the payer.

Comments 0

Views 326

Coding Top 10: New Patient Billing During Public Health Emergency, HOPD Prior Authorization Tracking Number, Charging Patients PPE Cleaning Fees

AUG 19, 2020 in Ask the Expert, Coding Updates, Coding Top 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 428

Charging Patients PPE Cleaning Fees

AUG 14, 2020 in Ask the Expert, Exams

We have heard that some dental practices are charging a personal protective equipment (PPE) cleaning fee. Are ophthalmologists allowed to charge a separate fee to patients?

Comments 0

Views 300

CPT Code for Removal of Hydrus Stent

AUG 14, 2020 in Ask the Expert, Glaucoma

The facility is billing CPT code 65235 Removal of foreign body, intraocular; from anterior chamber of eye or lens for the removal of a hydrus implant. Is this correct?

Comments 0

Views 72

HOPD Prior Authorization Tracking Number

AUG 14, 2020 in Oculofacial, Ask the Expert

We are performing a blepharoplasty in the hospital outpatient department and have received a provisional affirmation to proceed. Does the surgeon’s claim require the 14-digit UTN?

Comments 0

Views 33

Correct Units for Jetrea

AUG 14, 2020 in Retina, Ask the Expert

Our physician injected a patient with Jetrea for vitreomacular adhesion. I am confirming we submit three units.

Comments 0

Views 33

EUA Same Day and Lens Removal

AUG 14, 2020 in Exams, Pediatric/Strabismus, Ask the Expert

Our pediatric surgeon performed an exam under anesthesia (EUA) along with removal of a cataract without implantation of IOL. We submitted the following but received a denial: 92018 66850 -RT How should we submit?

Comments 0

Views 42

ICD-10 Code for Inferior Oblique Overaction

AUG 14, 2020 in ICD-10, Pediatric/Strabismus, Ask the Expert, Oculofacial

I am searching for an inferior oblique overaction ICD-10 diagnosis code.

Comments 0

Views 106

New Patient Billing During Public Health Emergency

AUG 14, 2020 in Ask the Expert, Telemedicine

During our office closure for COVID-19, a former patient of ours had multiple conversations with our on-call physician, none of which were submitted to insurance. She is now coming in for an exam. Because we have not billed an exam in over four years, is she considered new o…

Comments 0

Views 58

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