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.
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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.

Comments 0

Views 713

Congratulations to OCS and OCSR Designees

AUG 08, 2023 in Modifiers, Cornea, Pediatric/Strabismus, Cataract/Anterior Segment, Coding Updates, CPT, Exams, Glaucoma, Testing Services, ICD-10, Oculofacial, Coding Competency, Retina

Here is an updated list of individuals who have passed the Ophthalmic Coding Specialist and/or Ophthalmic Coding Specialist Retina exams in 2023.

Comments 0

Views 700

Unbundling Ptosis Repair and Blepharoplasty

AUG 04, 2023 in Oculofacial, Modifiers, Ask the Expert, Coding Competency

If the surgeon performs a bilateral repair of blepharoptosis (CPT code 67904) and bilateral upper lid blepharoplasty (CPT code 15823), would we add modifier –59 to unbundle?

Comments 0

Views 82

Can We Bill Medicare for an Assistant Surgeon

JUL 19, 2023 in Modifiers, Coding Competency, Oculofacial, Ask the Expert, Pediatric/Strabismus, CPT

Are we able to bill Medicare for an assistant surgeon for 68720 Dacryocystorhinostomy?

Comments 0

Views 40

How to Find the Correct NDC

JUL 19, 2023 in Pediatric/Strabismus, Coding Competency, Ask the Expert, Oculofacial

I have no experience adding a National Drug Code (NDC) to a claim but need to for therapeutic Botox. How do I find the correct code?

Comments 0

Views 37

Ready to Use JZ Modifier by July 1?

MAY 31, 2023 in Glaucoma, Coding Competency, Retina, Ask the Expert, Oculofacial

The Academy and AAOE Fact Sheet: JW and JZ Modifiers provides ophthalmic-specific guidance for the implementation of JZ modifier by July 1.

Comments 0

Views 3008

How to Bill Wastage for Botox and Two Patients

MAY 30, 2023 in Ask the Expert, Oculofacial, Modifiers, CPT

We have two Medicare patients who received medical botox the same day from the same vial. One received 50 units and the other 25, leaving 25 units of wastage. What is the best way to report this?

Comments 0

Views 369

Coding Top 10 - April 2023

APR 11, 2023 in Pediatric/Strabismus, CPT, Retina, Coding Competency, Cataract/Anterior Segment, Exams, Oculofacial, Coding Top 10, E/M, 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 846

Moderate Level Visit for Oculofacial Surgery

APR 10, 2023 in E/M, Exams, Ask the Expert, Oculofacial

Are we able to bill a level 4 evaluation and management E/M (99214) or a comprehensive Eye visit code (92014) for patients that schedule oculofacial surgeries?

Comments 0

Views 34

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 857

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 578

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 889

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 925

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 59

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 787

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 108

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 641

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 163

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 619

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 16

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