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 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 70 results
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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 1024

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 75

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 397

Coding Top 10 - March 2022

MAR 03, 2022 in Coding Top 10, Coding Updates, Pediatric/Strabismus, Glaucoma, Coding Competency, ICD-10, Cataract/Anterior Segment, CPT, Modifiers, Exams, Oculofacial, Ask the Expert, Retina

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

Comments 0

Views 909

Can modifier -59 be appended to the mullerectomy if two separate incisions were not documented?

MAR 02, 2022 in Oculofacial, Ask the Expert, Coding Top 10

I have a surgeon that performed a blepharoplasty (CPT code 15823) and Mullerectomy (CPT code 67908). Can modifier -59 be appended to the mullerectomy if two separate incisions were not documented?

Comments 0

Views 36

Congratulations to OCS and OCSR Designees

DEC 08, 2021 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 343

Coding Top 10 - September 2021

SEP 22, 2021 in Retina, Oculofacial, Testing Services, ICD-10, Cataract/Anterior Segment, Exams, Glaucoma, Coding Top 10, Ask the Expert, Coding Updates

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

Comments 0

Views 843

Please clarify the current bundling policy or if these codes can be billed as separate procedures? Do we use 67903 or 67904 Ptosis and 15823 Blepharoplasty?

SEP 22, 2021 in Oculofacial, Ask the Expert

Please clarify the current bundling policy or if these codes can be billed as separate procedures? Do we use 67903 or 67904 Ptosis and 15823 Blepharoplasty?

Comments 0

Views 352

When performing external ocular photography of patients prior to upper lid blepharoplasties, must the picture itself be tagged by patient name, chart number and date of service?

SEP 08, 2021 in Testing Services, Oculofacial, Ask the Expert

When performing external ocular photography of patients prior to upper lid blepharoplasties, must the picture itself be tagged by patient name, chart number and date of service?

Comments 0

Views 27

HOPD Prior Authorization Tracking Number

AUG 14, 2020 in Oculofacial, Ask the Expert

We are performing a blepharoplasty in the hospital outpatient department and have received a provisional affirmation to proceed. Does the surgeon’s claim require the 14-digit UTN?

Comments 0

Views 50

ICD-10 Code for Inferior Oblique Overaction

AUG 14, 2020 in ICD-10, Pediatric/Strabismus, Ask the Expert, Oculofacial

I am searching for an inferior oblique overaction ICD-10 diagnosis code.

Comments 0

Views 992

Frequency of punctal plugs

AUG 14, 2020 in Ask the Expert, Oculofacial

We have a patient requesting quick-dissolving plugs, which require reinsertion monthly. How often can we insert punctal plugs on a single patient?

Comments 0

Views 164

Prior Authorization for Medicare

JUN 24, 2020 in Ask the Expert, Oculofacial

I recently heard Medicare requires a prior authorization on blepharoplasties. In the past we’ve been unable to prior authorize services with Medicare. Is this new?

Comments 0

Views 121

Prior Authorization of Blepharoplasty and Botox Procedures Required Starting July 1

JUN 03, 2020 in Oculofacial, Ask the Expert

Hospital outpatient departments must preauthorize blepharoplasty and Botox procedures performed on or after July 1, but the process can begin June 17.

Comments 0

Views 3590

Unsuccessful Probing of Nasal Lacrimal Duct

MAR 01, 2020 in Coding Updates, CPT, Ask the Expert, Coding Top 10, Oculofacial

Question: Our surgeon dilated and probed the patient’s right lacrimal duct. However, the probing was unsuccessful. Should we submit CPT code 68810 Probing of nasolacrimal duct, with or without irrigation, with modifier -52 for reduced services?

Comments 0

Views 195

Coding Top 10: Frequency of Retina OCT, Frequency of Billing Fundus Photography and Superglue to Eye

MAR 01, 2020 in Testing Services, Exams, Cataract/Anterior Segment, Coding Top 10, Oculofacial, Ask the Expert, Glaucoma, Modifiers, Coding Updates

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The March coding selections include: Frequency of Retina OCT, Frequency of Billing Fundus Photography and Superglue to Eye

Comments 0

Views 2791

Adjustment to Frontalis Sling

DEC 18, 2019 in Oculofacial, Ask the Expert

Question: How do you bill for frontalis sling adjustment?

Comments 0

Views 912

ICD-10 Code for Squamous Cell Carcinoma of Skin of Eyelid

DEC 18, 2019 in Ask the Expert, Oculofacial

Question: Is ICD-10 code C44.12- Squamous cell carcinoma of skin of eyelid, including canthus really C44.122 for the right eyelid and C44.129 for the left eyelid?

Comments 0

Views 122

CPT Code for Globe Exploration

DEC 11, 2019 in Ask the Expert, Oculofacial

Question: Our surgeon performed an exploration of the left globe on a patient who was thought to may have a ruptured globe due to blunt trauma, but fortunately none was found. The surgeon did not explore the orbit, only the globe. What CPT code should be billed?

Comments 0

Views 3817

CPT code 15004 Denied by Medicare

DEC 11, 2019 in Ask the Expert, Oculofacial

Question: Our surgeon performed and billed for CPT code 67966 Excision and repair of eyelid, along with 15004 Surgical preparation of recipient site. Medicare denied 15004. The surgeon feels this is incorrect. Should we have billed this differently?

Comments 0

Views 837

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