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.
1-20 of 92 results
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Coding Top 10 - March 2023

MAR 10, 2023 in Retina, Testing Services, Exams, CPT, Cornea, Pediatric/Strabismus, Coding Competency, Cataract/Anterior Segment, Modifiers, Coding Top 10, 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 168

Eyelid Modifiers or Eye Modifiers

MAR 10, 2023 in Ask the Expert, Coding Competency, Oculofacial, Modifiers

What modifier(s) should we use when billing for CPT 11440 – “Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less” when the procedure is done on the upper…

Comments 0

Views 50

Coding Top 10 - February 2023

FEB 03, 2023 in Retina, Oculofacial, Cataract/Anterior Segment, Coding Competency, Coding Top 10, Cornea, CPT

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

Comments 0

Views 654

Billing for 0207T

FEB 02, 2023 in Ask the Expert, Cornea, Coding Competency, Oculofacial, CPT

When our ophthalmologist performs Lipiflow, we bill our Medicare contractor the unlisted CPT because the Category III reimbursement does not cover the expense of the supplies to perform this service. Medicare paid with the unlisted code, other payers do not. Are we able to c…

Comments 0

Views 101

Post-Op Photos

FEB 02, 2023 in CPT, Oculofacial, Ask the Expert

We have a relatively new oculoplastic surgeon who sometimes does post-op photos. Are we able to bill for the photos?

Comments 0

Views 68

Coding Top 10 - January 2023

JAN 20, 2023 in Exams, Oculofacial, Coding Competency, Cataract/Anterior Segment, Modifiers, Ask the Expert, E/M, Coding Top 10, Retina, Testing Services, CPT

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

Comments 0

Views 560

Canceled Cataract Surgery for Chalazion Removal

JAN 19, 2023 in CPT, Ask the Expert, Oculofacial

A patient was scheduled for cataract surgery but presented to the ambulatory surgery center (ASC) on the scheduled day of surgery with a large infected chalazion. The surgeon canceled the cataract surgery and removed the chalazion instead. How do we properly code this proced…

Comments 0

Views 47

Congratulations to OCS and OCSR Designees

JAN 02, 2023 in Modifiers, Cornea, Pediatric/Strabismus, Cataract/Anterior Segment, Coding Updates, CPT, Exams, Glaucoma, Testing Services, ICD-10, Oculofacial, Coding Competency, Retina

Individuals who who have passed the Ophthalmic Coding Specialist and/or Ophthalmic Coding Specialist Retina exams.

Comments 0

Views 690

Coding Top 10 - December 2022

DEC 01, 2022 in Coding Top 10, Testing Services, Coding Competency, Exams, E/M, Retina, Cataract/Anterior Segment, Oculofacial, Ask the Expert, CPT, 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 499

Free Tarsal Graft

DEC 01, 2022 in Oculofacial, Ask the Expert, CPT

Our oculofacial provider performed a “free tarsal graft” from the right upper lid to the right lower lid to repair defect from a recent Mohs procedure. What would be the appropriate CPT code?

Comments 0

Views 47

Coding Top 10 - November 2022

NOV 14, 2022 in Coding Competency, Coding Top 10, Pediatric/Strabismus, Retina, Trauma Coding, Exams, Cataract/Anterior Segment, Testing Services, Oculofacial, Ask the Expert

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

Comments 0

Views 526

Exploration of the Medial Upper Lid

NOV 14, 2022 in Oculofacial, Ask the Expert

During blepharoplasty, our surgeons perform an exploration of the medial upper lid for possible foreign body. There was no foreign body but excessive scar tissue. They debulked and biopsied the scar tissue. What CPT code is appropriate to bill for the exploration?

Comments 0

Views 27

Coding Top 10 - AAO 2022

OCT 20, 2022 in Coding Top 10, Cataract/Anterior Segment, Oculofacial, Retina, Ask the Expert, Testing Services, Coding Competency, Glaucoma, Exams, Pediatric/Strabismus

The Academy's coding experts answer the top coding questions from the annual meeting.

Comments 0

Views 587

Chalazion With Kenalog Injection

OCT 20, 2022 in Coding Competency, Ask the Expert, Pediatric/Strabismus, Oculofacial

One of our doctors would like to treat chalazion with Kenalog injection. Do you know the proper code we should be using?

Comments 0

Views 266

Coding Top 10 - September 2022

SEP 20, 2022 in Pediatric/Strabismus, Ask the Expert, Oculofacial, Exams, Coding Top 10, Cataract/Anterior Segment, Retina, Testing Services, Trauma Coding, Coding Competency, 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 566

Possible Foreign Body Removal During Blepharoplasty Surgery

SEP 20, 2022 in Ask the Expert, Trauma Coding, Oculofacial

We had one of our surgeons perform an exploration of the medial upper lid for possible foreign body during a blepharoplasty procedure. There was no foreign body but excessive scar tissue. She debulked and biopsied the scar tissue and sent it to pathology.

Comments 0

Views 44

CPT for Botox Injection

SEP 19, 2022 in Oculofacial, Coding Competency, Ask the Expert

What is the difference between using a 64612 vs. CPT 64615 for injection of Botox for blepharospasm?

Comments 0

Views 846

Coding Top 10 - August 2022

AUG 16, 2022 in Coding Top 10, ICD-10, Modifiers, Cataract/Anterior Segment, CPT, Retina, Pediatric/Strabismus, Telemedicine, Cornea, Testing Services, Trauma Coding, Exams, Coding Competency, Ask the Expert, 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 1127

Billing Diagnosis for Biopsies

AUG 15, 2022 in Oculofacial, Ask the Expert, Coding Competency

I often see eyelid lesions that I know are benign; however, I do not always know the precise name a pathologist would give the lesion. To be safe, I send it for confirmatory histopathology. What is the best practice here, do I have to bill it as a biopsy even when I know…

Comments 0

Views 106

Correcting Ptosis Procedure

AUG 15, 2022 in Ask the Expert, Oculofacial, Pediatric/Strabismus

A patient had bilateral ptosis surgery at an ambulatory surgery center (CPT 67904 Mod: 50) During 90-day global period, the patient was seen in the office by the same surgeon, and it was determined that the right eye needed adjustment. Additional ptosis procedure was perform…

Comments 0

Views 81

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