Coding News and Expert Advice

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Coding Top 10: Patient Balance with Medicare as Secondary Payer, Lysis of Adhesions Along with Cataract Surgery and OTC Drug Order with Eye Visit Codes

MAY 08, 2019 in CPT, Exams, Testing Services, Cornea, Coding Top 10, Cataract/Anterior Segment, Retina

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The April coding selections include: Patient Balance with Medicare as Secondary Payer, Lysis of Adhesions Along with Cataract Surgery and OTC Drug Order…

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Views 64

Removal of DSEK

MAY 07, 2019 in Cornea, Ask the Expert, CPT

Question: What procedure code is appropriate for the removal of DSEK because the patient has endophthalmitis?

Comments 0
Views 55

Correct NDC When Wasting Photrexa Viscous

MAY 07, 2019 in Cornea, Ask the Expert

Question: It is my understanding that Photrexa viscous will not always be used during the procedure. When only the Photrexa is administered, would it be more appropriate to bill with NDC 25357-023-01 with J2787 as that is the more accurate NDC?

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Views 20

CPT Code for Conjunctival Peritomy and Exploration

MAY 07, 2019 in Cornea, CPT, Ask the Expert

Question: Our surgeon plans to perform a conjunctival peritomy/scleral exploration due to a slow leak from a previous pars plana vitrectomy. The surgery will consist of make an incision in the conjunctiva and pulled back to explore the sclera, and possibly suture, if needed.…

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Views 27

CPT Code for Extraction of a Loa Loa Eye Worm

MAY 07, 2019 in Ask the Expert, CPT, Cornea, Cataract/Anterior Segment

Question: What is the best CPT code for extraction of a Loa Loa eye worm from the subconjunctival space?

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Views 35

OTC Drug Order With Eye Visit Codes

MAY 07, 2019 in Ask the Expert, CPT, Exams

Question: CPT language for comprehensive Eye visit codes indicate that at least one of the required items, such as “Prescription of medication” must be documented. Can the prescription be an over-the-counter drug?

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Views 65

Patient Balance with Medicare as Secondary Payer

MAY 07, 2019 in Exams, Ask the Expert

Question: Our patient has Medicare as a secondary payer, which has a higher allowable than the commercial primary, leaving a patient balance. Do we collect this amount from the patient?

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Views 111

Manual Break of Posterior Synechiolysis

MAY 07, 2019 in Cataract/Anterior Segment, Ask the Expert, CPT

Question: Our physician manually broke a posterior synechiolysis between iris and lens. Is there an existing CPT code that is best, or would we use an unlisted code?

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Views 34

Using New ERG Codes Same Session

MAY 07, 2019 in Ask the Expert, Testing Services, Retina

Question: Are the new Electroretinography (ERG) codes bundled together?

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Views 26

Explantation of Presbyopic Inlay

MAY 07, 2019 in CPT, Ask the Expert, Cornea

Question: Our surgeon needs to remove the presbyopic inlay due to complications. What is the best CPT code?

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Views 21

Lysis of Adhesions Along with Cataract Surgery

MAY 07, 2019 in Ask the Expert, CPT, Cataract/Anterior Segment

Question: Am I able to submit for lysis of adhesions separately from cataract surgery, or would this qualify for CPT code 66982 Complex cataract surgery?

Comments 0
Views 68

Billing Interpretation of Fundus Photos

MAY 06, 2019 in Retina, CPT, Ask the Expert, Testing Services

Question: In our rural community, primary care physicians are asking us to provide the interpretation and report on photos taken in their office for patients with known diabetic retinopathy to meet their Healthcare Effectiveness Data and Information Set (HEDIS) requirements.…

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Views 482

Telehealth Retinal Codes

MAY 06, 2019 in CPT, Testing Services, Retina, Ask the Expert

Our primary care group has a fundus camera. They want to perform the test and have our physician provide the interpretation and report. How do we submit these services?

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Views 860

Payer Documentation Requirements When Injecting Eylea

APR 11, 2019 in Retina, Ask the Expert, Coding Updates

What are the payer documentation requirements when injecting Eylea?

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Views 140

Coding Top 10: CPT Code for XEN-EX, Drug Code for CXL and CPT Code for New Technology IDx-DR

MAR 21, 2019

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The April coding selections include: CPT Code for XEN-EX, Drug Code for CXL and CPT Code for New Technology IDx-DR

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Views 567

CPT code for New Technology IDx-DR

MAR 18, 2019 in CPT, Ask the Expert, Testing Services, Retina

Question: Our practice may purchase the new IDx-DR device that used autonomous artificial intelligence to detect and interpret diabetic retinopathy. Is there a billable CPT code?

Comments 0
Views 248

Drug Code for CXL

MAR 18, 2019 in Cornea, Ask the Expert

Question: Does Corneal Cross-linking (CXL) have a drug code, or are we to continue using the unlisted code?

Comments 0
Views 65

Two ERGs The Same Day

MAR 18, 2019 in Retina, Testing Services, Ask the Expert

Question: Can we bill for both CPT codes 92273 Electroretinography (ERG), full field and 92274 ERG, multi field the same day?

Comments 0
Views 52

CPT Code YAG Laser for IOL Deposit

MAR 18, 2019 in Cataract/Anterior Segment, Ask the Expert, CPT

Question: A patient presented with deposits and pigment on the anterior surface of an IOL. The surgeon used a YAG laser. What is the appropriate CPT code to submit?

Comments 0
Views 132

CPT Code for XEN-EX

MAR 18, 2019 in CPT, Glaucoma, Ask the Expert

Question: I’ve read that there is a difference in billing for XEN EX than the traditional placement of XEN 45 that is placed ab interno. What CPT code do we submit?

Comments 0
Views 209

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