Coding News and Expert Advice

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Coding Top 10: Usage of miLoop in Cataract Surgery, CPT Code for Swabbing Cornea and Complex Retina Repair without Membrane Peel

AUG 01, 2019 in Retina, Oculofacial, Exams, Cornea, Coding Top 10, Modifiers, Testing Services, Cataract/Anterior Segment, CPT

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The August coding selections include: Usage of miLoop in Cataract Surgery, CPT Code for Swabbing Cornea and Complex Retina Repair without Membrane Peel

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Views 821

Did she keep Oxervate question? If yes, then make title 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 50

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 54

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?

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Views 87

Coding Top 10: Billing for Injection Related to Pterygium Surgery, Billing Exams in the Global Period and Resolved Diagnosis Follow-Up

JUL 12, 2019 in Retina, Testing Services, CPT, Cataract/Anterior Segment, Exams, Cornea, Coding Top 10, Glaucoma, Modifiers, Oculofacial

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The July coding selections include: Billing for Injection Related to Pterygium Surgery, Billing Exams in the Global Period and Resolved Diagnosis Follow…

Comments 0
Views 1006

Referring Patient to Partner During Global Period

JUL 08, 2019 in Ask the Expert, Retina, Testing Services, 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 199

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 306

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 126

Determining Risk for Immature Retina

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 42

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 148

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 366

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?

Comments 0
Views 308

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?

Comments 0
Views 177

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 150

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.…

Comments 0
Views 102

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?

Comments 0
Views 142

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…

Comments 0
Views 189

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?

Comments 0
Views 100

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?

Comments 0
Views 187

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…

Comments 0
Views 71

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