Coding News and Expert Advice

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1-20 of 57 results

SEP 10, 2019 in CPT, Ask the Expert, Exams, Modifiers, Cataract/Anterior Segment

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 254

Surgery Requiring General Anesthesia

SEP 10, 2019 in Cornea, Ask the Expert, Modifiers

Question: The surgeon performed CPT code 65222 -RT Removal of foreign body, external eye; corneal, with slit lamp under general anesthesia for a pediatric patient. Is there an additional modifier to append?

Comments 0
Views 55

Coding Top 10: Eye Visit Code Application, Surgery Requiring General Anesthesia and Instratromal Injection CPT Code

SEP 10, 2019 in Exams, Pediatric/Strabismus, CPT, ICD-10, Cornea, Coding Top 10, Retina, Cataract/Anterior Segment, Modifiers, Ask the Expert

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The September coding selections include: Eye Visit Code Application, Surgery Requiring General Anesthesia and Instratromal Injection CPT Code

Comments 0
Views 535

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, Ask the Expert, 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

Comments 0
Views 1021

Bilateral Punctal Plug Denial

JUL 31, 2019 in CPT, Cornea, Modifiers, Ask the Expert

Question: I performed bilateral punctal plugs and submitted to Novitas Medicare CPT code 68761 with modifier -50 and 1 unit. I received a denial due to incorrect modifier. Is there another modifier that should be used?

Comments 0
Views 207

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 126

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 1085

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 222

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 345

Billing of Cancelled Surgery

MAR 18, 2019 in Ask the Expert, Modifiers

Question: When a patient cancels elective surgery planned for later in the day, can we still bill for the physician’s time?

Comments 0
Views 221

Oct. 1 CCI Edits Impact Biopsy and Integumentary Lesion Excision Codes

OCT 01, 2018 in Oculofacial, Coding Updates, Modifiers

CMS has released the current Correct Coding Initiative Edits (CCI), Version 24.3, which goes into effect Oct 1. These edits bundle two or more services together. Always look at each code combination when two or more services are being performed as not all codes show a bundle…

Comments 0
Views 592

Billing Pterygium Excision with AMT

AUG 21, 2018 in Cornea, Modifiers, Ask the Expert, CPT

Question: Can we bill CPT codes 65426 Excision of pterygium; with graft and 65779 AMT sutured together?

Comments 0
Views 440

Payment for Usage of Modifiers -62 or -80

JUL 24, 2018 in CPT, Ask the Expert, Modifiers

Question: Is there a reduction in payment if an assistant-at surgery is used versus a co-surgeon?

Comments 0
Views 106

Order of Modifiers

JUN 12, 2018 in Modifiers, Ask the Expert, CPT

Does the modifier order make a difference?

Comments 0
Views 811

Comanagement in Another State

JUN 12, 2018 in Cataract/Anterior Segment, Ask the Expert, Modifiers, CPT

Can comanagement occur across state lines when there are different Medicare Administrative Contractors?

Comments 0
Views 56

Payment for Assistant at Surgery

JUN 12, 2018 in Ask the Expert, Modifiers, CPT

Question: My surgeon was an assistant during a procedure with a retina specialist. The operative report clearly states why the assistant was necessary. However, reimbursement was minimal. Any guidance?

Comments 0
Views 77

Billing for Emergency Cancellation of Surgery

APR 24, 2018 in Ask the Expert, Modifiers

We saw a patient in our ASC for surgery. During the preoperative administration of medication, his hypertension presented a complication where we couldn't get his blood pressure under control. Instead of surgery, we had to send him to the emergency department. Can the facili…

Comments 0
Views 175

Billing Unilateral Services with Bilateral Diagnoses

APR 24, 2018 in Modifiers, CPT, Ask the Expert

Commercial payers denied our services when we appended modifiers -RT or -LT, but the diagnosis is a bilateral code. Should we appeal?

Comments 0
Views 205

Billing for 2 Shunts in the Same Eye

APR 24, 2018 in Modifiers, CPT, Glaucoma, Ask the Expert

The payer denied CPT code 66185 Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft when billed on separate lines for both superior and inferior tubes in the right eye. Should we have submitted with modifier -50 instead?

Comments 0
Views 142

Billing Exams Without Insurance Credentialing

MAR 22, 2018 in Testing Services, Modifiers, Ask the Expert, Exams

We have a new physician joining our practice sooner than her license is available and prior to credentialing. Can we bill under the group with a specific modifier? I heard about locum tenens.

Comments 0
Views 354

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