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.
Fundamentals of Coding Top 10 - Special Edition

AUG 14, 2023 in Oculofacial, Coding Top 10, Telemedicine, Cataract/Anterior Segment, E/M, Coding Competency, Retina, Testing Services, Diabetes, Modifiers, Exams, CPT

This month's special edition Coding Top 10 includes questions from the 2023 Fundamentals of Ophthalmic Coding Course presented on June 27 in collaboration with the Academy’s Young Ophthalmologist (YO) Committee.

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Views 770

Interpreting Remote Fundus Photography

AUG 04, 2023 in Retina, Testing Services, Telemedicine, Ask the Expert, Diabetes, Coding Competency

Can ophthalmologists work with internal medicine physicians in caring for diabetic patients where internal medicine provides fundus photography (CPT code 92250 -TC) and the ophthalmologist provides the interpretation (CPT code 92250 –26)?

Comments 0

Views 112

Coding Top 10 - July 2022

JUL 19, 2022 in Cataract/Anterior Segment, Glaucoma, Testing Services, Coding Top 10, ICD-10, Diabetes, CPT, Exams, Modifiers, Retina, Ask the Expert, Coding Competency

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

Comments 0

Views 36

Local Coverage Determination Policies (LCDs)

JUL 18, 2022 in Ask the Expert, Testing Services, Coding Competency, Exams, Retina, Diabetes, Coding Top 10

We are having trouble getting paid for OCTs. How would I know if my Medicare administrative contractor (MAC) has a policy?

Comments 0

Views 279

Coding Top 10 - June 2022

MAY 31, 2022 in CPT, Cataract/Anterior Segment, Coding Updates, Diabetes, Ask the Expert, Testing Services, Exams, Oculofacial, ICD-10, Retina, Glaucoma, Coding Top 10, Modifiers

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

Comments 0

Views 60

Does the ICD-10 Code Trigger Multiple Procedure Payment Reduction?

MAY 23, 2022 in Testing Services, Diabetes, Ask the Expert, Coding Top 10

Our office often bills 92242 and 92134 together on patients with moderate diabetic retinopathy with macular edema and retinal hemorrhages. We have heard that coding the same diagnosis for both tests will trigger a multiple procedure payment reduction, reducing the OCT reimbu…

Comments 0

Views 1

Prediabetes ICD-10 Code

OCT 06, 2016 in Diabetes, ICD-10, Ask the Expert

What code should we use when a patient is not diagnosed with diabetes, but has symptoms?

Comments 0

Views 1253

Laterality with Diabetes Codes

OCT 06, 2016 in ICD-10, Diabetes, Ask the Expert

Do all diabetes ICD-10 codes require laterality as of Oct. 1, 2016?

Comments 0

Views 16

ICD-10 Diabetes Codes Without Ocular Complications

AUG 10, 2016 in Diabetes, ICD-10, Retina, Ask the Expert

There is no code for diabetes type 1 or type 2 that includes "without ocular complications" (i.e., no diabetic retinopathy). The only available codes are E10.9 or E11.9, which do not seem correct. What diagnosis code should we submit when the patient has no ocular complicati…

Comments 0

Views 2238

How to Bill for Testing Glucose During Exam

JUL 19, 2016 in Ask the Expert, Testing Services, Diabetes

Question: We have a glucose monitor to check blood sugar during visits, when needed. I am unable to locate an allowable for this in the Medicare Part B fee schedule. Is there a specific code we should submit?

Comments 0

Views 94

Diabetes With Macular Edema ICD-10 Coding

DEC 02, 2015 in Ask the Expert, Diabetes

When filing a claim to a commercial payer for a patient with diabetes, are we required to bill the diabetes and macular edema separately like ICD-9? If so, which ICD-10 codes should we submit?

Comments 0

Views 116

Should you report insulin use for patients with diabetes?

OCT 20, 2015 in Ask the Expert, ICD-10, Diabetes

Question: Should we report insulin use Z79.4 for our patients with diabetes?

Comments 0

Views 9

How to code diabetes with no ophthalmic disease progression

OCT 20, 2015 in Diabetes, ICD-10, Ask the Expert

Question: What is the best diagnosis code to use when a patient is sent to our practice because they have diabetes, but no ophthalmic disease progression is diagnosed?

Comments 0

Views 3

ICD-10 Diagnosis Code for 250.03 Type 1 Diabetes Mellitus, Juvenile, Uncontrolled?

JUN 16, 2015 in Diabetes, ICD-10, Ask the Expert

Question: What would be the appropriate ICD-10 code for 250.03 Type 1 Diabetes mellitus, juvenile, uncontrolled?

Comments 0

Views 329

ICD-10 Code for Prediabetes

JUN 16, 2015 in Ask the Expert, Diabetes

Question: How do you code for prediabetes?

Comments 0

Views 3717

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