Coding News and Expert Advice

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Coding Top 10: Dilation for E/M Codes, Advanced Glaucoma Testing and Postoperative Exams When Self Pay

JUN 11, 2019 in CPT, Cornea, Coding Top 10, Pediatric/Strabismus, Exams, Testing Services, Oculofacial, Retina, Glaucoma, Cataract/Anterior Segment

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The June coding selections include: Dilation for E/M Codes, Advanced Glaucoma Testing and Postoperative Exams When Self Pay

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Views 72

Dilation for E/M Codes

JUN 10, 2019 in Exams, Ask the Expert

Question: Our billing department has stated dilation is only necessary for eye visit codes, but not E/M codes. Is our pediatric ophthalmologist not required to dilate when billing 99214?

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Views 85

Postoperative Exams When Self Pay

JUN 10, 2019 in Exams, Pediatric/Strabismus, Retina, Glaucoma, Oculofacial, Cataract/Anterior Segment, Ask the Expert, Cornea

Question: When a self-paying patient has medically necessary surgery, are postoperative exams included or separately billed?

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Views 59

Surgery Without Office Exam

JUN 10, 2019 in Ask the Expert, Exams, Cataract/Anterior Segment

Question: One of our surgeons is injured and unable to perform cataract surgery. Is another surgeon of the practice able to perform surgery without seeing the patient in the office?

Comments 0
Views 53

EUA During Cataract Surgery

JUN 10, 2019 in Cataract/Anterior Segment, Ask the Expert, Exams

Question: Our surgeon performed cataract surgery on a Down syndrome patient. During the surgery he performed an exam under anesthesia (EUA) due to the patients cognitive and emotional limitations. Previously, we have billed CPT code 92499 to bill the exam under anesthesia.…

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Views 24

Dilation Pertaining to Review of Systems

JUN 10, 2019 in Ask the Expert, Exams

Question: Our physician was told that regardless if the patient is new or established, that you need at least 10 review of systems records documented if the patient is dilated. Is this true?

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Views 47

Coding Top 10: Patient Balance with Medicare as Secondary Payer, Lysis of Adhesions Along with Cataract Surgery and OTC Drug Order with Eye Visit Codes

MAY 08, 2019 in CPT, Exams, Testing Services, Cornea, Coding Top 10, Cataract/Anterior Segment, Retina

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The May coding selections include: Patient Balance with Medicare as Secondary Payer, Lysis of Adhesions Along with Cataract Surgery and OTC Drug Order wi…

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Views 155

OTC Drug Order With Eye Visit Codes

MAY 07, 2019 in Ask the Expert, CPT, Exams

Question: CPT language for comprehensive Eye visit codes indicate that at least one of the required items, such as “Prescription of medication” must be documented. Can the prescription be an over-the-counter drug?

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Views 91

Patient Balance with Medicare as Secondary Payer

MAY 07, 2019 in Exams, Ask the Expert

Question: Our patient has Medicare as a secondary payer, which has a higher allowable than the commercial primary, leaving a patient balance. Do we collect this amount from the patient?

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Views 161

Payer Processing of Claim

MAR 18, 2019 in Exams, Ask the Expert

Question: We collected the Medicare deductible of a patient we treated in January and then submitted the claim two weeks later. Upon receipt of the remittance advice, it states the patient has satisfied the deductible and we now owe a refund. I thought Medicare processed c…

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Views 60

Coding Top 10: Goniotomy and Other Glaucoma Surgery Same Day, Epilation Sooner than Eight Weeks and New Diagnosis Prompting Another Injection Less than 28 Days

MAR 13, 2019 in ICD-10, CPT, Glaucoma, Coding Top 10, Oculofacial, Cataract/Anterior Segment, Cornea, Pediatric/Strabismus, Exams, Retina

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: Goniotomy and Other Glaucoma Surgery Same Day, Epilation Sooner than Eight Weeks and New Diagnosis Prompting Another…

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Views 1302

Billing for Post-Cataract Glasses

MAR 12, 2019 in Ask the Expert, Cataract/Anterior Segment, Exams

Question: There is a discrepancy between our office and a referring office as to how Medicare handles a change in glasses post cataract extraction. Is the patient obligated to have both eyes operated on before Medicare will allow for bilateral lenses?

Comments 0
Views 334

Complete Review of Systems When Not Pertinent to Exam

MAR 12, 2019 in Exams, Ask the Expert

Question: If a technician or physician is unable to perform a complete review of systems because they are not pertinent to today’s exam, can he receive full credit for stating all others are not pertinent to the patient’s condition?

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Views 153

Language for Chief Complaint

MAR 12, 2019 in Exams, Ask the Expert

Question: We recently obtained a satellite office that uses “vision stable” as the chief complaint for established glaucoma patients. Is this acceptable?

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Views 189

ICD-10 Code for Corneal Scar Status-Post Laceration

MAR 12, 2019 in Exams, Cornea, ICD-10, Ask the Expert

Question: We have a patient who is status-post corneal laceration and now has scarring. What is the best ICD-10 code to use as we are unsure about sequela codes?

Comments 0
Views 110

Correct Taxonomy Codes

FEB 04, 2019 in ICD-10, Oculofacial, Ask the Expert, Exams

Question: We are considering switching to the unique taxonomy code for our oculoplastic physician. Can you tell me if 2082S0099X – Allopathic & Osteopathic Physicians – Plastic Surgery is appropriate?

Comments 0
Views 247

Balance Billing for Refractions

FEB 04, 2019 in Ask the Expert, Exams

Question: We performed a refraction on a Medicare patient. The secondary insurance has an allowable on the refraction charge. Can we balance bill the patient the difference between our charge and the secondary insurance allowable?

Comments 0
Views 361

Invalid Diagnosis Code

DEC 03, 2018 in Ask the Expert, Exams, ICD-10

Question: I billed with ICD-10 code H57.8 Other specified disorders of eye and adnexa and received a denial from Medicare stating this is invalid. Are they no longer accepting this diagnosis?

Comments 0
Views 340

Dilation Requirement for Exams

SEP 19, 2018 in Ask the Expert, CPT, Exams

Question: What exam codes require dilation?

Comments 0
Views 589

Charging for Missed Appointments

SEP 19, 2018 in Exams, Ask the Expert

Question: Can we charge a patient for missed appointments?

Comments 0
Views 179

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