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 often. Academy coding advice is based on current information. 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 996 results
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Coding Top 10 - March 2023

MAR 10, 2023 in Retina, Testing Services, Exams, CPT, Cornea, Pediatric/Strabismus, Coding Competency, Cataract/Anterior Segment, Modifiers, Coding Top 10, Oculofacial

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

Comments 0

Views 438

Internal Subspecialty Referrals, New or Established

MAR 10, 2023 in Exams, Coding Competency, Ask the Expert

When the cataract specialist in our group practice refers a new patient to me, a retina specialist, can I bill the office visit as a new patient? Each physician in our practice utilizes primary ophthalmology and subspecialty taxonomies.

Comments 0

Views 60

Documentation Location for Activities of Daily Living

MAR 10, 2023 in Coding Competency, Ask the Expert, Exams, Cataract/Anterior Segment

For cataract surgery, where do we document the patient’s specific activity of daily living (ADL) that is affected?

Comments 0

Views 70

Supply of Bandage Contact Lens

MAR 10, 2023 in Cornea, Ask the Expert

Does Medicare bundle the cost of a bandage contact lens (BCL) for ocular surface disease (OSD) with 92071, or can you file 99070 supply code as well?

Comments 0

Views 68

Eyelid Modifiers or Eye Modifiers

MAR 10, 2023 in Ask the Expert, Coding Competency, Oculofacial, Modifiers

What modifier(s) should we use when billing for CPT 11440 – “Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less” when the procedure is done on the upper…

Comments 0

Views 92

New Dry Eye Treatment

MAR 10, 2023 in Testing Services, Coding Competency, Cornea, Ask the Expert

Can iLux be billed with 0207T when it is a covered service? iLux is not automated but the description for 0207T states automated.

Comments 0

Views 50

Skin Cancer Screening

MAR 10, 2023 in Coding Competency, Ask the Expert

How do we bill skin cancer screenings?

Comments 0

Views 26

Atropine Therapy

MAR 10, 2023 in Exams, Pediatric/Strabismus, E/M, Ask the Expert, Coding Competency

How do we bill for atropine therapy?

Comments 0

Views 19

Who Documents the Order for Testing?

MAR 10, 2023 in Testing Services, Ask the Expert, Coding Competency

Can a scribe document the testing service that the physician orders under their log in? The documentation states, "written by (scribe’s name) acting as a scribe for (physician’s name)." Or is the physician required to login and order the test?

Comments 0

Views 59

Intravitreal Injections in the Ambulatory Surgery Center

MAR 10, 2023 in Ask the Expert, Retina

How do we bill for intravitreal injections of Avastin when performed in an ambulatory surgery center (ASC)?

Comments 0

Views 31

Assistant to Surgery Modifier

MAR 10, 2023 in Modifiers, Ask the Expert, Cataract/Anterior Segment

Our surgeon performed complex cataract surgery with a retina surgeon. Our practice management billing software does not accept modifier -62 with CPT 66982. Can we bill the surgery with modifier 62?

Comments 0

Views 25

Evaluation and Management Resources

MAR 09, 2023 in Ask the Expert, Coding Competency, E/M, Exams

I am a comprehensive ophthalmologist in a rural setting, and I only use Eye visit codes but would like to start using Evaluation and Management (E/M) codes. Where should I go to find resources on how to use E/M codes?

Comments 0

Views 84

Verify, Then Trust Technology

MAR 06, 2023 in Coding Competency, Ask the Expert, Testing Services

Learn about the common deficiencies in Electronic Health Records (EHRs), and how the verification process will help you to trust this essential technology.

Comments 0

Views 107

New vs. Established: Nuances for Ophthalmology Subspecialties

FEB 28, 2023 in Ask the Expert, Coding Competency

New vs. Established: Nuances for Ophthalmology Subspecialties

Comments 0

Views 205

Failure to Document Medical Necessity Continues

FEB 15, 2023 in Ask the Expert, Cataract/Anterior Segment

Prepayment provider-specific probe results from Palmetto GBA reveal insufficient documentation continues to plague providers.

Comments 0

Views 218

Coding Top 10 - February 2023

FEB 03, 2023 in Retina, Oculofacial, Cataract/Anterior Segment, Coding Competency, Coding Top 10, Cornea, CPT

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

Comments 0

Views 659

Planning for Complex Cataract Surgery

FEB 03, 2023 in Cataract/Anterior Segment, Ask the Expert, CPT

A patient has phacodonesis and is scheduled for complex cataract surgery. There is no mention of sutures, Malyugin ring or hyper mature cataract in the exam notes. In documenting the surgical order, is it better to plan for complex and down code or plan for standard and up c…

Comments 0

Views 151

YAG for Epithelial Ingrowth

FEB 02, 2023 in Ask the Expert, Cornea, CPT, Coding Competency

My physician uses a YAG laser to treat epithelial ingrowth on a patient. Would we bill the YAG procedure code of 66821 and the diagnosis of H18.891? Or should we be using the unlisted code 66999?

Comments 0

Views 55

Keratoptosthesis

FEB 02, 2023 in Cornea, CPT, Ask the Expert, Coding Competency

I perform combined surgery when the cornea is cloudy, and the retina surgeon needs to perform a vitrectomy. I begin by removing the patient's cornea and suturing in a temporary keratoprosthesis. The retinal surgeon then performs the vitrectomy. Afterwards, I cut all sutures,…

Comments 0

Views 49

New Patient Injection Denied for Frequency

FEB 02, 2023 in Retina, CPT, Ask the Expert

A new patient was seen in our office and received an Eylea injection the same day. Medicare denied the injection as performed too soon. We were unaware the patient had an injection two weeks earlier at another office. There is no advance beneficiary notice on file, so we tho…

Comments 0

Views 83

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