Coding News and Expert Advice

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Minor Ophthalmological Bundling Edits Effective April 1

MAR 18, 2019 in Coding Updates

Minor Ophthalmological Bundling Edits Effective April 1, 2019

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Views 41

Coding Top 10: Goniotomy and Other Glaucoma Surgery Same Day, Epilation Sooner than Eight Weeks and New Diagnosis Prompting Another Injection Less than 28 Days

MAR 13, 2019 in ICD-10, CPT, Glaucoma, Coding Top 10, Oculofacial, Cataract/Anterior Segment, Cornea, Pediatric/Strabismus, Exams, Retina

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The March coding selections include: Goniotomy and Other Glaucoma Surgery Same Day, Epilation Sooner than Eight Weeks and New Diagnosis Prompting Another…

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Views 802

Goniotomy and Other Glaucoma Surgery Same Day

MAR 12, 2019 in Glaucoma, CPT, Ask the Expert

Question: Is it appropriate to report CPT code 66174 for therapeutic dilation of Schlemm's Canal and code 65820 for a goniotomy when these two procedures are performed on the same eye to treat glaucoma?

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Views 93

Billing for Post-Cataract Glasses

MAR 12, 2019 in Ask the Expert, Cataract/Anterior Segment, Exams

Question: There is a discrepancy between our office and a referring office as to how Medicare handles a change in glasses post cataract extraction. Is the patient obligated to have both eyes operated on before Medicare will allow for bilateral lenses?

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Views 65

CPT Code for Multiple Molluscum Lesions

MAR 12, 2019 in CPT, Pediatric/Strabismus, Ask the Expert

Question: We have a 2-year-old who had molluscum lesions on each upper eyelid, as well as on his face and body which was 18 total lesions. The parents asked if our surgeon would remove all, and he did. How best do we submit this service?

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Views 35

Reporting Wastage in Box 19 on Claim Form

MAR 12, 2019 in Retina, Ask the Expert

Question: Should we report what was injected in the eye only, or if there is reportable wastage, do we include this number in box 19?

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Views 45

New Diagnosis Prompting Another Injection Less than 28 Days

MAR 12, 2019 in Ask the Expert, Retina

Question: I treated a patient with Eylea in the right eye for diabetic macular edema. Two weeks later she developed a retinal vein occlusion with macular edema in the same eye, so I injected Lucentis. Since there is a new diagnosis and the drug has been changed, will the fac…

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Views 96

Complete Review of Systems When Not Pertinent to Exam

MAR 12, 2019 in Exams, Ask the Expert

Question: If a technician or physician is unable to perform a complete review of systems because they are not pertinent to today’s exam, can he receive full credit for stating all others are not pertinent to the patient’s condition?

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Views 87

Epilation Sooner than Eight Weeks

MAR 12, 2019 in Oculofacial, Cornea, Ask the Expert

Question: We have a patient that returns frequently for epilation. He would like to come sooner than eight weeks and feels that it is medically appropriate. We did bill and received a denial due to frequency from Medicare. How do we get this paid?

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Views 105

CPT Code for I&D of Chalazion

MAR 12, 2019 in Pediatric/Strabismus, Ask the Expert, Oculofacial, CPT

Question: What is the appropriate CPT code for incision and drainage of a chalazion instead of excision?

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Views 83

Language for Chief Complaint

MAR 12, 2019 in Exams, Ask the Expert

Question: We recently obtained a satellite office that uses “vision stable” as the chief complaint for established glaucoma patients. Is this acceptable?

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Views 110

ICD-10 Code for Corneal Scar Status-Post Laceration

MAR 12, 2019 in Exams, Cornea, ICD-10, Ask the Expert

Question: We have a patient who is status-post corneal laceration and now has scarring. What is the best ICD-10 code to use as we are unsure about sequela codes?

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Views 34

Coding Top 10: Billing Corneal Puncture in Office, Balance Billing for Refractions and Excision of Eyelash

FEB 05, 2019 in Coding Top 10

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

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Views 1154

Correct Taxonomy Codes

FEB 04, 2019 in ICD-10, Oculofacial, Ask the Expert, Exams

Question: We are considering switching to the unique taxonomy code for our oculoplastic physician. Can you tell me if 2082S0099X – Allopathic & Osteopathic Physicians – Plastic Surgery is appropriate?

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Views 170

Excision of Eyelash

FEB 04, 2019 in CPT, Ask the Expert, Cornea

Question: Our surgeon has to excise a lash that is ingrown into the lid. Is there a CPT code that is appropriate?

Comments 0
Views 184

Foreign Body with Abrasion Noted

FEB 04, 2019 in ICD-10, Ask the Expert, Cornea

Question: We have a patient who had a corneal foreign body removed. An abrasion was also noted. Our physician wants to bill both ICD-10 codes: T15.02XA Foreign body of cornea and S05.02XA Corneal abrasion without foreign body. Could this cause a denial?

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Views 128

Guidelines for ADL Forms

FEB 04, 2019 in Ask the Expert, Cataract/Anterior Segment

Question: For coding purposes, what are the guidelines on the questions we must ask for activities of daily living prior to cataract surgery?

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Views 107

Repeat Laser for New Tear in Global Period

FEB 04, 2019 in Retina, Ask the Expert, CPT

Question: If a patient has CPT code 67105 Laser for retinal tear and a new tear is found within the global period, can we bill the laser again?

Comments 0
Views 109

Standing Orders Billed to Non-Medicare Payers

FEB 04, 2019 in Testing Services, Ask the Expert

Question: Does the insurance rule that physicians must examine the patient and then order any necessary tests apply to Medicare only or all payers?

Comments 0
Views 125

Global Period for Additional Lasers

FEB 04, 2019 in CPT, Retina, Ask the Expert

Question: Do we restart the global period for additional laser treatment when billing CPT code 67145 Prophylaxis of retinal detachment, even though we don’t bill the additional laser?

Comments 0
Views 72

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