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 733 results
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16 Questions and Answers About New E/M Definitions and Guidelines

DEC 23, 2020 in E/M, Ask the Expert

Get clarification on new E/M guidelines effective Jan. 1 from questions answered by the American Medical Association and the Academy. For more information, visit aao.org/em.

Comments 0

Views 2417

Countdown to new E/M requirements beginning Jan. 1

DEC 14, 2020 in Ask the Expert, E/M

Follow these steps to help your practice shore up any outstanding items before the evaluation and management (E/M) documentation requirements go into effect on Jan. 1. For more information, the Academy has continued education at aao.org/em.

Comments 0

Views 407

Coding Top 10: Billing Irrigation for Chemical Injury, Audit Tool Applied to Eye Visit Codes, Complete Review of Systems When Not Pertinent to Exam

DEC 08, 2020 in E/M, Ask the Expert, 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.

Comments 0

Views 613

Countdown to New E/M Requirements: Preparation for January 1

DEC 01, 2020 in Exams, Ask the Expert, E/M

The Academy has your implementation strategy for the new evaluation and management (E/M) changes, so that your practice is ready on Jan. 1. Use these steps to ensure your practice has a smooth transition. You can find further education at aao.org/em.

Comments 0

Views 444

Example of risk factors for minor surgery

NOV 06, 2020 in E/M, Ask the Expert

Question: What is an example under risk of complications and/or morbidity or mortality of patient management of minor surgery with identified patient or procedure risk factors?

Comments 0

Views 376

Do non-covered tests count in MDM

NOV 06, 2020 in Exams, Ask the Expert, E/M

Question: Is the refraction, Amsler grid, glare testing, etc., considered tests for amount and/or complexity of data to be reviewed an analyzed with the new E/M documentation criteria?

Comments 0

Views 260

Artificial tears qualify as prescription medication

NOV 06, 2020 in Ask the Expert, E/M

Question: Under risk of complications and/or morbidity or mortality of patient, do artificial tears for the dry eye patient count as prescription drug management?

Comments 0

Views 197

Countdown to New E/M Requirements: Medically Relevant History

NOV 04, 2020 in Ask the Expert, Exams, E/M

With the new requirements of evaluation and management (E/M) beginning Jan. 1, 2021, we can no longer keep documenting as we always have. So how do you begin making the change? These five steps will guide you on your journey.

Comments 0

Views 1081

Billing for Smoking Cessation Counseling

NOV 02, 2020 in E/M, Exams, Ask the Expert

I was made aware there are two CPT codes for smoking cessation counseling. Are they appropriate for ophthalmologists to use?

Comments 0

Views 301

EUA Same Day and Lens Removal

NOV 02, 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 -57 66850 -RT How should we submit?

Comments 0

Views 64

Billing Irrigation for Chemical Injury

NOV 02, 2020 in E/M, Ask the Expert, Exams

Our physician irrigated a patient’s eyes using the Morgan lens device after a chemical injury. Is this separately billable?

Comments 0

Views 93

Superglue to Eye

NOV 02, 2020 in Ask the Expert, E/M, Exams

Question: Our patient got superglue in their right eye. Our physician examined the patient and debrided the lashes. What CPT code is billed for the removal of glue from lashes?

Comments 0

Views 495

Eye Visit Code Application

NOV 02, 2020 in Exams, E/M, Ask the Expert

Question: Our physician heard that ophthalmologists can no longer bill Eye visit codes. Is this true?

Comments 0

Views 633

Dilation for E/M Codes

NOV 02, 2020 in Exams, Ask the Expert, E/M

Question: Our billing department has stated dilation is only necessary for Eye visit codes, but not E/M codes. Is our pediatric ophthalmologist not required to dilate when billing 99214?

Comments 0

Views 1652

Audit Tool Applied to Eye Visit Codes

NOV 02, 2020 in Ask the Expert, Exams, E/M

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 570

Complete Review of Systems When Not Pertinent to Exam

NOV 02, 2020 in Exams, E/M, 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?

Comments 0

Views 78

Established Patient ROS Documentation

NOV 02, 2020 in Ask the Expert, Exams, E/M

Question: Is there a specific amount of review of systems (ROS) we should be documenting for established patients?

Comments 0

Views 399

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 667

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 1171

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 760

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