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 often. Academy coding advice is based on current information. 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.
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Sept 2023 – Special Edition: Retina Coding Summer Symposium Top 10

SEP 12, 2023 in E/M, Coding Top 10, Retina, Coding Competency, Modifiers

This special edition of the Coding Top 10 includes questions from the 2023 Retina Coding Summer Symposium presented July 25 and includes a couple video highlights from the session. If you missed the live event, you can purchase the recording through Nov. 20.

Comments 0

Views 193

Modifier for Injection Performed During Global Period

SEP 12, 2023 in Ask the Expert, Coding Competency, Modifiers, Retina

During the global period where the injection is performed for a diagnosis that differs from the surgery, is modifier -58 or -79 appropriate?

Comments 0

Views 90

Intravitreal Injection and a Vitreous Tap

SEP 12, 2023 in Ask the Expert, Modifiers, Retina

If we are billing an intravitreal injection (CPT code 67028) for endophthalmitis antibiotics and doing a vitreous tap (CPT code 67015), are those okay to unbundle?

Comments 0

Views 33

Order for Modifiers When Reporting Medication HCPCS Codes

SEP 11, 2023 in Modifiers, Retina, Ask the Expert

If RT or LT modifiers are required when reporting medication HCPCS codes, does the anatomical modifier go before or after the -JZ modifier?

Comments 0

Views 23

Billing Kenalog from a Single Use Vial

SEP 11, 2023 in Modifiers, Ask the Expert, Retina

How would we bill Kenalog from a single-use vial containing 40 mg?

Comments 0

Views 29

Fundamentals of Coding Top 10 - Special Edition

AUG 14, 2023 in Oculofacial, Coding Top 10, Telemedicine, Cataract/Anterior Segment, E/M, Coding Competency, Retina, Testing Services, Diabetes, Modifiers, Exams, CPT

This month's special edition Coding Top 10 includes questions from the 2023 Fundamentals of Ophthalmic Coding Course presented on June 27 in collaboration with the Academy’s Young Ophthalmologist (YO) Committee.

Comments 0

Views 713

Congratulations to OCS and OCSR Designees

AUG 08, 2023 in Modifiers, Cornea, Pediatric/Strabismus, Cataract/Anterior Segment, Coding Updates, CPT, Exams, Glaucoma, Testing Services, ICD-10, Oculofacial, Coding Competency, Retina

Here is an updated list of individuals who have passed the Ophthalmic Coding Specialist and/or Ophthalmic Coding Specialist Retina exams in 2023.

Comments 0

Views 700

Unbundling Ptosis Repair and Blepharoplasty

AUG 04, 2023 in Oculofacial, Modifiers, Ask the Expert, Coding Competency

If the surgeon performs a bilateral repair of blepharoptosis (CPT code 67904) and bilateral upper lid blepharoplasty (CPT code 15823), would we add modifier –59 to unbundle?

Comments 0

Views 82

Office Visit with Corneal Foreign Body Removal

AUG 04, 2023 in Coding Competency, Modifiers, Ask the Expert, Exams

Can you bill an office visit with a corneal foreign body removal?

Comments 0

Views 96

Coding Top 10 - July 2023

JUL 20, 2023 in Retina, Glaucoma, CPT, Coding Top 10, Coding Competency, Cataract/Anterior Segment, Pediatric/Strabismus, Exams, Modifiers, E/M

Get trusted answers to your coding questions from the Academy's coding experts, so you can bill and code with confidence.

Comments 0

Views 586

Do We Use Modifier -JW with Residual Eylea?

JUL 20, 2023 in Modifiers, Retina, Coding Competency, Ask the Expert

Our ophthalmologist reports that if we have Eylea remaining in the syringe after an injection, we should bill the waste with modifier -JW. Is this correct?

Comments 0

Views 91

Can We Bill Medicare for an Assistant Surgeon

JUL 19, 2023 in Modifiers, Coding Competency, Oculofacial, Ask the Expert, Pediatric/Strabismus, CPT

Are we able to bill Medicare for an assistant surgeon for 68720 Dacryocystorhinostomy?

Comments 0

Views 40

Co-managed Cataract Surgery with a Goniotomy

JUL 19, 2023 in Cataract/Anterior Segment, Coding Competency, Modifiers, Ask the Expert, Glaucoma

What is the appropriate way to bill for co-managed cataract surgery with a goniotomy when the optometrist will take over complete care of the patient following the surgery?

Comments 0

Views 73

Is Modifier-JZ Appended to Implanted Drugs?

JUL 19, 2023 in Modifiers, Retina, Coding Competency, Ask the Expert

Will we need to append modifier -JZ to implanted drugs (Ozurdex, Illuvien, Yutiq)?

Comments 0

Views 44

Is Modifier-JZ for All Insurance?

JUL 19, 2023 in Coding Competency, Modifiers, Ask the Expert

Is the use of modifier -JZ just for Medicare or for all insurance companies?

Comments 0

Views 125

Coding Top 10 - June 2023

JUN 12, 2023 in Retina, CPT, Pediatric/Strabismus, Cataract/Anterior Segment, Coding Top 10, Glaucoma, Exams, Modifiers, Coding Competency, E/M

Get trusted answers to your coding questions from the Academy's coding experts, so you can bill and code with confidence.

Comments 0

Views 830

Insertion of Intraocular Lens Prosthesis (Secondary Implant) With Tension Ring

JUN 09, 2023 in Ask the Expert, Modifiers, Cataract/Anterior Segment

Do we bill 66982 with a 52 modifier since the capsular tension ring was used?

Comments 0

Views 74

How to Bill Wastage for Botox and Two Patients

MAY 30, 2023 in Ask the Expert, Oculofacial, Modifiers, CPT

We have two Medicare patients who received medical botox the same day from the same vial. One received 50 units and the other 25, leaving 25 units of wastage. What is the best way to report this?

Comments 0

Views 369

Coding Top 10 - May 2023

MAY 09, 2023 in E/M, CPT, Pediatric/Strabismus, Exams, Retina, Modifiers, Cataract/Anterior Segment, Coding Competency, 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 869

YAG Laser When Performed in Global Period

MAY 08, 2023 in Cataract/Anterior Segment, Modifiers, Ask the Expert

Which is the correct modifier to use for a YAG laser capsulotomy, CPT code 66821, performed during the post-op period of the initial cataract surgery, 78 or 79?

Comments 0

Views 273

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