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 955 results
1 2 3 4 5 Next »

3 Reasons to Confirm Designated Taxonomy Codes Are Correct

DEC 05, 2022 in Ask the Expert, Coding Competency

Three reasons to confirm designated taxonomy codes are correct.

Comments 0

Views 9

You Better Watch Out — Auditors Are Checking Their List Twice

DEC 05, 2022 in Cataract/Anterior Segment, Retina, Coding Competency, Ask the Expert

The Centers for Medicare & Medicaid Services (CMS) contracts with a Supplemental Medical Review Contractor (SMRC) and partnering Noridian as the national contractor, to help lower improper payment rates by conducting post-payment audits.

Comments 0

Views 29

Coding Top 10 - December 2022

DEC 01, 2022 in Coding Top 10, Testing Services, Coding Competency, Exams, E/M, Retina, Cataract/Anterior Segment, Oculofacial, Ask the Expert, CPT, Modifiers

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

Comments 0

Views 113

Experimental Denial for Amniotic Membrane Tissue

DEC 01, 2022 in Ask the Expert, Coding Competency

A local insurance carrier is denying insertion of an amniotic membrane tissue, stating CPT 65778 is experimental and not covered. How do we get paid?

Comments 0

Views 11

Post Cataract Glasses Prescription

DEC 01, 2022 in Coding Competency, Ask the Expert

What is required on a prescription for glasses after cataract surgery for traditional Medicare to pay?

Comments 0

Views 13

Avastin Coding and Billing

DEC 01, 2022 in Retina, Ask the Expert

How often can intraocular bevacizumab (Avastin) be billed? I have read a few things that state 28 days but at one point was told 31 days.

Comments 0

Views 23

Documenting the Need for YAG Capsulotomy — First Coast

DEC 01, 2022 in Cataract/Anterior Segment, Ask the Expert

We received a comparative billing report noting us as outliers for YAG capsulotomy (CPT code 66821). On First Coast’s website it says the local coverage determination (LCD) for 66821 has been retired. On what guidelines should we base our documentation?

Comments 0

Views 20

Free Tarsal Graft

DEC 01, 2022 in Oculofacial, Ask the Expert, CPT

Our oculofacial provider performed a “free tarsal graft” from the right upper lid to the right lower lid to repair defect from a recent Mohs procedure. What would be the appropriate CPT code?

Comments 0

Views 3

How to Bill for Co-Managed Cataract Patients

DEC 01, 2022 in Coding Competency, Cataract/Anterior Segment, Ask the Expert, Modifiers

When our ophthalmologist sees the patient for post-op day one is it appropriate to bill 66984 –54 and no additional post-op days? Is reimbursement different when the surgeon performs 2 weeks of postop care and before transferring care to the co-managing provider?

Comments 0

Views 14

Lengthy Inpatient Consultation

NOV 30, 2022 in Exams, CPT, E/M, Ask the Expert

I am a pediatric ophthalmologist. While on call at our local hospital, I provided a lengthy inpatient consultation for a Medicare adult with preseptal cellulitis. After discharge from the hospital, the patient will follow up with the comprehensive ophthalmologist. What is th…

Comments 0

Views 4

Breaking Bundles

NOV 30, 2022 in Testing Services, Ask the Expert, Modifiers, Coding Competency

I am aware of the Medicare correct coding initiative (CCI) bundle of 92250 on the same day as 92133 or 92134. Can the edit be unbundled if the diagnosis codes are different? For example, 92250 with a glaucoma diagnosis and 92134 with a retinal diagnosis. Also, do all other…

Comments 0

Views 24

Follow-Up Exam or Post-Op?

NOV 30, 2022 in Modifiers, Retina, Coding Competency, Ask the Expert

During a post-operative period of a vitrectomy with membrane peel to repair a retinal detachment with a single break, a patient was examined and a new retinal detachment due to proliferative vitreoretinopathy was diagnosed. Since these are different retinal detachment diagno…

Comments 0

Views 12

Complex Cataract Operative Report

NOV 30, 2022 in Ask the Expert, Cataract/Anterior Segment

Our ambulatory surgery center has an operative report template with the option to check a box at the end of the report if trypan, capsular tension ring or iris hooks were used during the case, making it complex. Is it sufficient to check the appropriate box or does it also n…

Comments 0

Views 15

Coding Top 10 - November 2022

NOV 14, 2022 in Coding Competency, Coding Top 10, Pediatric/Strabismus, Retina, Trauma Coding, Exams, Cataract/Anterior Segment, Testing Services, Oculofacial, 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 462

Possible Ruptured Globe

NOV 14, 2022 in Ask the Expert, Trauma Coding, Coding Competency

Our retina surgeon took a patient to surgery for a possible ruptured globe. The operative note states there was no ruptured globe, that the patient has a history of trauma with iridodialysis and persistent hypotony. The procedure consisted of inspection of the globe as well…

Comments 0

Views 38

Exploration of the Medial Upper Lid

NOV 14, 2022 in Oculofacial, Ask the Expert

During blepharoplasty, our surgeons perform an exploration of the medial upper lid for possible foreign body. There was no foreign body but excessive scar tissue. They debulked and biopsied the scar tissue. What CPT code is appropriate to bill for the exploration?

Comments 0

Views 23

Does National Government Services Allow Splitting Single-Use Vials of Botox?

NOV 14, 2022 in Ask the Expert, Coding Competency

We are seeing more botulinum toxin patients on the same day; there are opportunities to have three patients share a vial and only bill a small amount of wastage. After reviewing single-use coding, multiuse coding and blepharospasm documents as well as the NGS Medicare billin…

Comments 0

Views 29

Pediatric Cataract Surgery

NOV 13, 2022 in Cataract/Anterior Segment, Pediatric/Strabismus, Ask the Expert

What is the age limit for billing 66982 for pediatric patients?

Comments 0

Views 13

What Constitutes a Complex Cataract Surgery Case?

NOV 13, 2022 in Ask the Expert, Cataract/Anterior Segment

What constitutes a complex cataract surgery case?

Comments 0

Views 67

Exam Between Cataract Surgeries

NOV 13, 2022 in Coding Competency, Cataract/Anterior Segment, Exams, Ask the Expert

A patient has cataract surgery on their right eye and comes into the office the next day for their first postoperative appointment. During this appointment, the surgeon planned to go ahead with cataract surgery for the left eye. Can this visit be billed as an evaluation and…

Comments 0

Views 83

1-20 of 955 results
1 2 3 4 5 Next »

Narrow Your Results

Select Code Type

Select Topic

Select Category

About Our Coding Experts

OUR SITES

FOLLOW THE ACADEMY