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  • 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 634 results
    Bundling Edits Impacting Ophthalmology Effective Jan. 1
    JAN 08, 2020 in Coding Updates
    The Centers for Medicare & Medicaid Services began implementing its current Correct Coding Initiative Edits (CCI), version 26.0 on Jan. 1.
    • Comments 0
    • Views 675
    Patient Requiring Ahmed and Baerveldt Implants in Same Session
    DEC 18, 2019 in Glaucoma, Ask the Expert
    Question: We have a patient who requires both Ahmed and Baerveldt implants due to the patient’s severity of vision loss and to aid in better IOP control. Since implants are both CPT code 66180 Aqueous shunt to extraocular equatorial plate reservoir; external approach; with g…
    • Comments 0
    • Views 27
    Audit Tool Applied to Eye Visit Codes
    DEC 18, 2019 in Ask the Expert, Exams
    Question: Our compliance department is in the process of reviewing our new patient Eye visit codes, and they are down-coding our comprehensive codes to intermediate exams because we are missing the review of systems and past, family and social histories. Do we need to have t…
    • Comments 0
    • Views 166
    Dextenza Billing
    DEC 18, 2019 in Cataract/Anterior Segment, Ask the Expert
    Question: How do we bill for Dextenza when used with cataract surgery?
    • Comments 0
    • Views 74
    Billing Ophthalmoscopy Testing
    DEC 18, 2019 in Ask the Expert, Testing Services, Retina
    Question: Can we still submit 92225/92226 Extended ophthalmoscopy?
    • Comments 0
    • Views 1181
    Adjustment to Frontalis Sling
    DEC 18, 2019 in Oculofacial, Ask the Expert
    Question: How do you bill for frontalis sling adjustment?
    • Comments 0
    • Views 11
    Billing for Beovu Injection
    DEC 18, 2019 in Ask the Expert, Coding Updates, Retina
    Question: What is the correct coding for the drug Beovu?
    • Comments 0
    • Views 205
    ICD-10 Code for Squamous Cell Carcinoma of Skin of Eyelid
    DEC 18, 2019 in Ask the Expert, Oculofacial
    Question: Is ICD-10 code C44.12- Squamous cell carcinoma of skin of eyelid, including canthus really C44.122 for the right eyelid and C44.129 for the left eyelid?
    • Comments 0
    • Views 5
    IOL Calculation in Operating Room
    DEC 18, 2019 in Pediatric/Strabismus, Ask the Expert
    Question: Our surgeon is performing cataract surgery on a child. The A-scan will be performed while in the operating room. Is this still billable?
    • Comments 0
    • Views 12
    Billing Punctal Plugs for Medicare
    DEC 18, 2019 in Modifiers, Ask the Expert, Cornea
    Question: How should I bill punctal plugs for Medicare patients? We always bill the Eye visit code with modifier -25, along with 68761 -RT and 68761 -LT, however Medicare is no longer processing the claim.
    • Comments 0
    • Views 38
    Separate Billing of Photrexa with Corneal Cross-linking
    DEC 18, 2019 in Cornea, Ask the Expert
    Question: When performing corneal cross-linking (CXL), do payers allow for separate billing of Photrexa?
    • Comments 0
    • Views 475
    Coding Top 10: ICD-10 Code for Failed Vision Screening and CPT Code for Globe Exploration
    DEC 12, 2019 in Coding Top 10, Coding Updates
    Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The December coding selections include: ICD-10 Code for Failed Vision Screening and CPT Code for Globe Exploration.
    • Comments 0
    • Views 510
    Unbundling Goniosynechialysis with Cataract Surgery
    DEC 11, 2019 in Glaucoma, Cataract/Anterior Segment, Ask the Expert
    Question: Is it appropriate to unbundle CPT code 65865 Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae, with cataract surgery?
    • Comments 0
    • Views 129
    Bleb Revision in Office
    DEC 11, 2019 in Glaucoma, Ask the Expert
    Question: Can a bleb revision be performed in the office setting?
    • Comments 0
    • Views 63
    Billing Plugs to Commercial Payer
    DEC 11, 2019 in Ask the Expert, Cornea
    Question: While Medicare bundles punctal plugs into the insertion code, I thought commercial payers pay separately, however A4263 for silicone, is being denied. Is there another code we should bill?
    • Comments 0
    • Views 137
    Excludes1 Edits Now Being Applied
    DEC 11, 2019 in Ask the Expert, Pediatric/Strabismus, ICD-10
    Question: There is an Excludes1 edit that states H50. strabismus codes cannot be submitted with H53. amblyopia codes for the same service. We are now seeing denials where previously payers were allowing us to bill both diagnoses. How should we go forward?
    • Comments 0
    • Views 111
    CPT Code for Globe Exploration
    DEC 11, 2019 in Ask the Expert, Oculofacial
    Question: Our surgeon performed an exploration of the left globe on a patient who was thought to may have a ruptured globe due to blunt trauma, but fortunately none was found. The surgeon did not explore the orbit, only the globe. What CPT code should be billed?
    • Comments 0
    • Views 103
    Consultation for Retinal Detachment
    DEC 11, 2019 in Exams, Retina, Ask the Expert
    Question: When the payer still recognizes consultation codes, should we use them when an optometrist sends a patient to us after a retinal detachment was discovered?
    • Comments 0
    • Views 38
    CPT code 15004 Denied by Medicare
    DEC 11, 2019 in Ask the Expert, Oculofacial
    Question: Our surgeon performed and billed for CPT code 67966 Excision and repair of eyelid, along with 15004 Surgical preparation of recipient site. Medicare denied 15004. The surgeon feels this is incorrect. Should we have billed this differently?
    • Comments 0
    • Views 39
    Audit Tool Applied to Eye Visit Codes
    DEC 11, 2019 in Exams, Ask the Expert
    Question: Our compliance department is in the process of reviewing our new patient Eye visit codes, and they are down-coding our comprehensive codes to intermediate, as we are missing the review of systems and past, family and social histories. Do we need to have this docume…
    • Comments 0
    • Views 79
    12345Next »
    1-20 of 634 results
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