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 83 results
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How to Perform Internal Chart Audits in 10 Steps

NOV 11, 2022 in Exams, Modifiers, Coding Competency, Ask the Expert, Testing Services

These steps will help you initiate your audit and see you through the entire process from identifying audit targets to implementing a plan to prevent the discovered deficiencies.

Comments 0

Views 154

Exam Billing When Performing Injections

OCT 20, 2022 in Ask the Expert, Modifiers, Exams, Retina

When can we bill for an exam when an intravitreal injection is performed on the same day?

Comments 0

Views 125

Coding Top 10 - September 2022

SEP 20, 2022 in Pediatric/Strabismus, Ask the Expert, Oculofacial, Exams, Coding Top 10, Cataract/Anterior Segment, Retina, Testing Services, Trauma Coding, Coding Competency, 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 536

Ophthalmic Biometry

SEP 20, 2022 in Coding Competency, Modifiers, Testing Services, Cataract/Anterior Segment, Ask the Expert

We filed 92136-TC and 92136-26 and identified which eye. I have filed several disputes, and those also have been denied. The payer told me the wrong modifier is being used.

Comments 0

Views 121

Coding Top 10 - August 2022

AUG 16, 2022 in Coding Top 10, ICD-10, Modifiers, Cataract/Anterior Segment, CPT, Retina, Pediatric/Strabismus, Telemedicine, Cornea, Testing Services, Trauma Coding, Exams, Coding Competency, Ask the Expert, 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 953

Coding Top 10 - July 2022

JUL 19, 2022 in Cataract/Anterior Segment, Glaucoma, Testing Services, Coding Top 10, ICD-10, Diabetes, CPT, Exams, Modifiers, Retina, Ask the Expert, Coding Competency

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Comments 0

Views 640

Global Period of Surgery Performed Out of State

JUL 15, 2022 in Coding Top 10, Retina, Modifiers, Ask the Expert, Coding Competency

I am performing retinal detachment (RD) surgery on a patient who was treated for RD in the same eye two months ago in another state. Since they are in the global period would I use modifier -58?

Comments 0

Views 80

EHR update automatically adding modifiers

JUL 15, 2022 in Modifiers, Coding Competency, Ask the Expert, Testing Services, Coding Top 10

Our electronic health records (EHR) software implemented a new version, and it now automatically adds modifier -25 when the physician performs an extended ophthalmoscopy or OCT. Is this a new rule, and is it correct?

Comments 0

Views 121

Provider Sees Patient for Two Exams Same Day

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

We saw a new patient in the morning for a complete eye exam. The patient came back that afternoon with acute angle closure. The patient was treated in the office for over an hour with multiple doses of eye drops. The patient returned the next day for a laser PI. Can we bill…

Comments 0

Views 101

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 1157

Discontinued Cataract/MIGS surgery

MAY 24, 2022 in Coding Top 10, Cataract/Anterior Segment, Ask the Expert, Modifiers

Our physician was performing a cataract extraction with IOL and iStent (CPT 66991). they were able to perform the cataract extraction and placement of the IOL but were unable to insert the iStent into the canal after several attempts. They stopped at that point of the proced…

Comments 0

Views 118

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 1436

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 528

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 128

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 651

Does This Support Modifier -59?

MAR 30, 2022 in Modifiers, Cataract/Anterior Segment, Ask the Expert, Coding Top 10

A physician performed complex cataract surgery 66982 OS on a patient and in the same session performed a 67005 OS. The op note reads: “One strand of vitreous was seen inferior-nasally so the anterior vitrectomy instrument was used to remove it.” Does this documentation sup…

Comments 0

Views 205

Is It Appropriate to Append Modifier -77 to a Diagnostic Test?

MAR 30, 2022 in Ask the Expert, Modifiers, Coding Top 10

Optical coherence tomography (OCT) was performed by an ophthalmologist, who then referred the patient to a retina specialist. The retina specialist performed and interpreted an OCT as well. Can we append modifier -77 in this scenario?

Comments 0

Views 79

Unilateral Contact Lens Fit

MAR 30, 2022 in Modifiers, Coding Top 10, Ask the Expert

CPT 92072 (fitting of contact lens for keratoconus) has a bilateral surgery indicator of “2” in Medicare’s database. Is it correct not to use modifier -50 and if one eye is fitted, use modifier -52?

Comments 0

Views 48

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 103

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 1089

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