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.
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Pop Quiz: Billing for New vs. Established Patients

MAY 31, 2022 in Ask the Expert, Coding Competency, Exams

Whether you are starting your own practice, joining a group practice, acquiring patients from another practice or opening a new office location across town, a practice transition will create situations in which it will be important to know if a patient is considered new or e…

Comments 0

Views 255

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 670

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 1248

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 231

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 205

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 105

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 196

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 92

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 497

During the pandemic, when patients had to be seen virtually, we were able to bill a video/telehealth appointment. Are we able to continue billing for telehealth visits?

MAR 15, 2022 in Exams, Modifiers, Telemedicine, Ask the Expert, Coding Top 10

During the pandemic, when patients had to be seen virtually, we were able to bill a video/telehealth appointment. Are we able to continue billing for telehealth visits?

Comments 0

Views 81

If a contact lens is stuck and the patient is unable to remove it, can you charge a foreign body removal code? Also, is an eyelash considered a foreign body?

MAR 15, 2022 in Exams, Ask the Expert, Coding Top 10, Coding Competency

If a contact lens is stuck and the patient is unable to remove it, can you charge a foreign body removal code? Also, is an eyelash considered a foreign body?

Comments 0

Views 129

Evaluation and Management Documentation for Glaucoma Suspect

MAR 15, 2022 in Ask the Expert, Coding Top 10, Coding Competency, Testing Services, Exams

A patient is a glaucoma suspect and has chronic dry eyes. The visual fields ordered and performed were suspicious for disease progression. The plan is for patient to follow up in 1-2 months with repeat visual field. What level evaluation and management (E/M) does the documen…

Comments 0

Views 134

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 981

Coding Top 10 - January 2022

JAN 26, 2022 in Glaucoma, Coding Updates, Cataract/Anterior Segment, Ask the Expert, Exams, Retina, Coding Top 10, ICD-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 1395

CPT codes for Medicare Part B patient with shingles

JAN 26, 2022 in Ask the Expert, Coding Top 10, Exams

Our doctor saw an existing patient with Medicare Part B in the hospital for a brief consult for shingles. Which range of CPT codes should we use?

Comments 0

Views 56

G2212 still valid code in 2022

JAN 26, 2022 in Coding Top 10, Ask the Expert, Exams

Is G2212 still a valid code in 2022?

Comments 0

Views 120

Glaucoma Screening Benefits Reminder

JAN 05, 2022 in Glaucoma, Ask the Expert, Exams

Carrier Medical Directors for Part B Medicare would like all ophthalmologists and their staff to recall the components of the glaucoma screening benefit.

Comments 0

Views 217

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 377

Coding Top 10 - November 2021

NOV 04, 2021 in Glaucoma, Cataract/Anterior Segment, Ask the Expert, Coding Updates, Exams, Pediatric/Strabismus, Coding Top 10, ICD-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 1349

Billing when not the attending physician

NOV 04, 2021 in Exams, Ask the Expert

One of our physicians was called in to check a patient while she was in observation care. We are not the attending physician. How do we bill for this as an ophthalmologist?

Comments 0

Views 122

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