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  • 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.

  • 12345
    1-20 of 96 results
    On-call Patients Seen on Weekend
    MAR 01, 2020 in Ask the Expert, Coding Updates, Exams, Coding Top 10
    Question: Our physician treated a patient over the weekend while on call for another practice. Can we bill CPT codes 92004 and 99050 Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (e.g., holida…
    • Comments 0
    • Views 255
    Superglue to Eye
    MAR 01, 2020 in Ask the Expert, Coding Updates, Coding Top 10, Exams
    Question: Our patient got superglue in their right eye. Our physician examined the patient and debrided the lashes. What CPT code is billed for the removal of glue from lashes?
    • Comments 0
    • Views 162
    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 1490
    Audit Tool Applied to Eye Visit Codes
    DEC 18, 2019 in Ask the Expert, Exams
    Question: Our compliance department is in the process of reviewing our new patient Eye visit codes, and they are down-coding our comprehensive codes to intermediate exams because we are missing the review of systems and past, family and social histories. Do we need to have t…
    • Comments 0
    • Views 320
    Consultation for Retinal Detachment
    DEC 11, 2019 in Exams, Retina, Ask the Expert
    Question: When the payer still recognizes consultation codes, should we use them when an optometrist sends a patient to us after a retinal detachment was discovered?
    • Comments 0
    • Views 61
    Audit Tool Applied to Eye Visit Codes
    DEC 11, 2019 in Exams, Ask the Expert
    Question: Our compliance department is in the process of reviewing our new patient Eye visit codes, and they are down-coding our comprehensive codes to intermediate, as we are missing the review of systems and past, family and social histories. Do we need to have this docume…
    • Comments 0
    • Views 132
    Operative Report Storage
    NOV 06, 2019 in Exams, Ask the Expert
    Question: Our surgical operative reports are kept in the electronic health record (EHR) system of the facility, not our practice. We have access to this EHR as we are under the same taxpayer identification number (TIN). Do we have to have a copy of the operative report in ou…
    • Comments 0
    • Views 109
    Established Patient ROS Documentation
    NOV 06, 2019 in Ask the Expert, Exams
    Question: Is there a specific amount of review of systems (ROS) we should be documenting for established patients?
    • Comments 0
    • Views 202
    Eye Visit Code Application
    SEP 10, 2019 in Exams, Ask the Expert
    Question: Our physician heard that ophthalmologists can no longer bill eye visit codes. Is this true?
    • Comments 0
    • Views 356
    Billing Exam for Separate Complaint
    SEP 10, 2019 in Cornea, CPT, Ask the Expert, Exams
    Question: Our physician saw an established patient complaining of red and itchy eyes. The Diagnosis is allergic conjunctivitis, and abrasion was found that required debridement. Can we bill the exam and the procedure?
    • Comments 0
    • Views 365
    After Hours Exam
    SEP 10, 2019 in Ask the Expert, Exams
    Question: Our physicians are seeing more patients after hours, due to patient emergencies, such as foreign bodies. Are we able to charge the payer or patient additional dollars for this service?
    • Comments 0
    • Views 156
    Return Exams for Corneal Rehab Prior to Surgery
    SEP 10, 2019 in Cornea, Ask the Expert, Exams
    Question: Patients return for multiple corneal rehabilitation therapies due to contact lens wear with our optometrist once cataract surgery has been determined medically necessary by one of the surgeons in the practice. Are these exams billable?
    • Comments 0
    • Views 64
    Billing Demodex
    JUL 31, 2019 in Ask the Expert, Exams, Testing Services
    Question: We recently acquired a microscope so I could look for a parasite (demodex) in patients’ lashes. Is this billable as a culture?
    • Comments 0
    • Views 120
    Oxervate Training
    JUL 31, 2019 in Exams, Cornea, Ask the Expert
    Question: When prescribed Oxervate for neurotrophic keratitis, the patient is required to return for training and care of vials. Can we bill insurance for the training, which is performed by the technician, if we have an order?
    • Comments 0
    • Views 106
    Unrelated Exam Same Day as Planned Surgery
    JUL 30, 2019 in Ask the Expert, Cataract/Anterior Segment, Modifiers, Exams
    Question: Our patient, who was scheduled to come today for a YAG Capsulotomy in the right eye, came in with a complaint of blurriness and flashes in the left eye. We did an exam of the left eye and performed the YAG in the right eye. How should we submit?
    • Comments 0
    • Views 183
    Billing Exams in the Global Period
    JUL 08, 2019 in Modifiers, Cataract/Anterior Segment, Exams, Ask the Expert
    Question: A patient 60 days into the global period for cataract surgery has been diagnosed with a post-vitreous detachment (PVD), which may or may not be related. The physician feels this should be billable. Should we append modifier -24?
    • Comments 0
    • Views 440
    Surgeon Treating Patient in Co-management
    JUL 08, 2019 in Exams, Cataract/Anterior Segment, Ask the Expert
    Question: A patient is being co-managed for cataract surgery and has now returned to the surgeon for a related complaint. Is the surgeon able to bill for the exam?
    • Comments 0
    • Views 178
    Referring Patient to Partner During Global Period
    JUL 08, 2019 in Ask the Expert, Retina, Exams, Modifiers, Cataract/Anterior Segment
    Question: Our patient is in the global period for cataract surgery, and it’s been determined she has cystoid macular edema (CME). We referred her to a retina specialist n our practice. Is the exam billable with modifier -24?
    • Comments 0
    • Views 256
    Determining for Retinopathy of Prematurity (ROP)
    JUL 08, 2019 in Ask the Expert, Retina, Exams
    Question: When billing E&M services, for a baby with immature retinas, what level of risk would be used? There was no retinopathy of prematurity (ROP) detected.
    • Comments 0
    • Views 106
    Resolved Diagnosis Follow Up
    JUL 08, 2019 in Exams
    Question: A patient has been seen for the last three visits for the same diagnosis. However, today the condition is resolved. Can we bill the same diagnosis?
    • Comments 0
    • Views 194
    12345
    1-20 of 96 results
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