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  • About Our Coding Experts

    About Our Coding Experts

    Our expert staff have decades of combined experience, covering all aspects of coding and reimbursement.

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  • 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 876 results
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    Mid-Year Forum 2022: Innovation in Ophthalmology and Its Impact on Coding, Coverage and Reimbursement
    APR 26, 2022
    Innovation in ophthalmology has always been central to our culture. While offering exciting opportunities for physician growth and patient care, innovation can affect coverage, patient access and reimbursement for physicians in complex ways, both directly and indirectly. The…
    • Comments 0
    • Views 95
    Coding Top 10 - May 2022
    APR 22, 2022 in ICD-10, Exams, Ask the Expert, Coding Updates, Glaucoma, Coding Competency, Retina, Coding Top 10, Modifiers, CPT, Cataract/Anterior Segment, 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 932
    YAG Laser for Aqueous Misdirection
    APR 22, 2022 in Ask the Expert, Glaucoma, Coding Top 10
    Patient with aqueous misdirection that I performed a YAG to the anterior hyaloid face through the open capsule of the pseudophakic eye. I was going to code it just as YAG capsulotomy but that doesn’t seem right. What is the code for this procedure? I read several articles a…
    • Comments 0
    • Views 77
    Comprehensive exam and Optos
    APR 22, 2022 in Exams, Retina, Coding Top 10, Ask the Expert
    Since it is not covered by insurance, can we bill the patient for Optos? Can we bill for a comprehensive examination when we use Optos even if we do not dilate the patient?
    • Comments 0
    • Views 160
    Comanagement and Post-Operative Billing
    APR 22, 2022 in Modifiers, Exams, Coding Top 10, Ask the Expert
    Can we abstain from billing the days/visits that we see post-ops in order to not disrupt the referring and comanaging billing for the full 90 days? Or are we required to bill for the days that the patient is under our care?
    • Comments 0
    • Views 127
    Eye Visit Codes for Inpatient Setting
    APR 22, 2022 in Ask the Expert, Coding Top 10, Coding Competency, Exams
    Can the Eye Visit codes only be used in the outpatient setting and not in the inpatient setting?
    • Comments 0
    • Views 78
    Lesion Removal MUEs
    APR 22, 2022 in Ask the Expert, Oculofacial, Modifiers, Coding Top 10
    Patient had lesions removed on all four eyelids. MUE states it is three. Can we bill two separate line items each with a 50 modifier?
    • Comments 0
    • Views 69
    New Light Adjustable IOL Coding and Billing
    APR 22, 2022 in Cataract/Anterior Segment, Coding Top 10, Coding Competency, Ask the Expert
    Can you offer any insight on the most appropriate way to bill the light adjustable IOL, RxSight? Would V2787 be an appropriate code since this seems to function most like a toric lens?
    • Comments 0
    • Views 68
    Punctal Plug Supply Billing
    APR 22, 2022 in Cornea, Coding Competency, Coding Top 10, Ask the Expert
    Are we able to bill patients directly for the lacrimal plugs due to Medicare bundling them with the plug placement procedures?
    • Comments 0
    • Views 87
    Ordered Tests and E/M Medical Decision-Making
    APR 21, 2022 in Ask the Expert, Exams, Coding Top 10
    If a provider orders an OCT to be performed before the patient’s next office visit could this be counted as ordering a unique test in the data category for medical decision-making even if the provider can bill for it when the patient comes in for the test?
    • Comments 0
    • Views 134
    Outpatient Office Visit During Inpatient Stay
    APR 21, 2022 in Exams, Coding Top 10, Coding Competency, Ask the Expert
    We recently had a patient sent to us from our local hospital. We coded the office visit with E/M code 99204 and billed for fundus photos, CPT 92250. Both the office visit and the photos were denied by Medicare, which said the place of service is inconsistent with the procedu…
    • Comments 0
    • Views 63
    Coding Top 10 - April 2022
    MAR 31, 2022 in Coding Competency, Modifiers, Coding Updates, Glaucoma, Ask the Expert, Pediatric/Strabismus, Cataract/Anterior Segment, CPT, ICD-10, Exams, Oculofacial, Retina, Coding Top 10
    Get trusted answers to your coding questions from the Academy's coding experts, so you can bill and code with confidence.
    • Comments 0
    • Views 375
    92136 vs 76519
    MAR 30, 2022 in Cataract/Anterior Segment, Coding Top 10, Ask the Expert
    When we perform optical biometry, we occasionally do not get the axial length (AL) due to the cataract but can get the remaining measurements. We perform ultrasound/immersion only for the AL. Is it more appropriate to charge 92136 or 76519?
    • Comments 0
    • Views 59
    Unified Program Integrity Contractor (UPIC) Audit
    MAR 30, 2022 in Ask the Expert, Coding Competency, Coding Top 10
    Could you advise me on how to move forward with a UPIC audit?
    • Comments 0
    • Views 53
    Does This Support Modifier -59?
    MAR 30, 2022 in Modifiers, Cataract/Anterior Segment, Ask the Expert, Coding Top 10
    A physician performed complex cataract surgery 66982 OS on a patient and in the same session performed a 67005 OS. The op note reads: “One strand of vitreous was seen inferior-nasally so the anterior vitrectomy instrument was used to remove it.” Does this documentation sup…
    • Comments 0
    • Views 57
    Interpretation and Report
    MAR 30, 2022 in Coding Competency, Ask the Expert, Coding Top 10
    Do I have to create a separate interpretation for OCT-RNFL or may I state “see OCT” in my plan?
    • Comments 0
    • Views 64
    XEN-EX: External Approach
    MAR 30, 2022 in Glaucoma, Coding Top 10, Ask the Expert
    Our vendor and Xen Gel state the billing code for the stent is 0449T but that is for an internal approach to the surgery, whereas my doctor uses an external approach. Would code 66183 be appropriate to use for the external approach?
    • Comments 0
    • Views 46
    Is It Appropriate to Append Modifier -77 to a Diagnostic Test?
    MAR 30, 2022 in Ask the Expert, Modifiers, Coding Top 10
    Optical coherence tomography (OCT) was performed by an ophthalmologist, who then referred the patient to a retina specialist. The retina specialist performed and interpreted an OCT as well. Can we append modifier -77 in this scenario?
    • Comments 0
    • Views 13
    Unilateral Contact Lens Fit
    MAR 30, 2022 in Modifiers, Coding Top 10, Ask the Expert
    CPT 92072 (fitting of contact lens for keratoconus) has a bilateral surgery indicator of “2” in Medicare’s database. Is it correct not to use modifier -50 and if one eye is fitted, use modifier -52?
    • Comments 0
    • Views 22
    Unable to Properly Fit Prokera
    MAR 30, 2022 in Coding Top 10, Ask the Expert, Cornea
    A cornea specialist asks if it is appropriate to bill for Prokera placement (65778) when the patient’s corneal anatomy caused the Prokera ring to be highly mobile on the eye and not stay in place. It had to be removed immediately.
    • Comments 0
    • Views 19
    1-20 of 876 results
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