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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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 711

Coding Top 10 - March 2023

MAR 10, 2023 in Retina, Testing Services, Exams, CPT, Cornea, Pediatric/Strabismus, Coding Competency, Cataract/Anterior Segment, Modifiers, Coding Top 10, 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 857

Supply of Bandage Contact Lens

MAR 10, 2023 in Cornea, Ask the Expert

Does Medicare bundle the cost of a bandage contact lens (BCL) for ocular surface disease (OSD) with 92071, or can you file 99070 supply code as well?

Comments 0

Views 610

New Dry Eye Treatment

MAR 10, 2023 in Testing Services, Coding Competency, Cornea, Ask the Expert

Can iLux be billed with 0207T when it is a covered service? iLux is not automated but the description for 0207T states automated.

Comments 0

Views 209

Coding Top 10 - February 2023

FEB 03, 2023 in Retina, Oculofacial, Cataract/Anterior Segment, Coding Competency, Coding Top 10, Cornea, CPT

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

Comments 0

Views 889

YAG for Epithelial Ingrowth

FEB 02, 2023 in Ask the Expert, Cornea, CPT, Coding Competency

My physician uses a YAG laser to treat epithelial ingrowth on a patient. Would we bill the YAG procedure code of 66821 and the diagnosis of H18.891? Or should we be using the unlisted code 66999?

Comments 0

Views 108

Keratoptosthesis

FEB 02, 2023 in Cornea, CPT, Ask the Expert, Coding Competency

I perform combined surgery when the cornea is cloudy, and the retina surgeon needs to perform a vitrectomy. I begin by removing the patient's cornea and suturing in a temporary keratoprosthesis. The retinal surgeon then performs the vitrectomy. Afterwards, I cut all sutures,…

Comments 0

Views 153

Billing for 0207T

FEB 02, 2023 in Ask the Expert, Cornea, Coding Competency, Oculofacial, CPT

When our ophthalmologist performs Lipiflow, we bill our Medicare contractor the unlisted CPT because the Category III reimbursement does not cover the expense of the supplies to perform this service. Medicare paid with the unlisted code, other payers do not. Are we able to c…

Comments 0

Views 949

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 213

Placing KeraNatural Rings

AUG 15, 2022 in Cornea, Ask the Expert

What is advised for coding when placing the KeraNatural rings and arcs for keratoconus?

Comments 0

Views 240

Traumatic Flap Dislocation

AUG 12, 2022 in Trauma Coding, Ask the Expert, Cornea

The patient has a traumatic dislocation of the Lasik flap in the right eye. The patient is new to us, as the Lasik was performed at another practice. Thirty minutes were spent in the minor procedure room repairing the Lasik flap. Which CPT code is best to bill?

Comments 0

Views 227

Punctal Plug Supply Billing

APR 22, 2022 in Cornea, Coding Competency, Coding Top 10, Ask the Expert

Are we able to bill patients directly for the lacrimal plugs due to Medicare bundling them with the plug placement procedures?

Comments 0

Views 432

Unable to Properly Fit Prokera

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

A cornea specialist asks if it is appropriate to bill for Prokera placement (65778) when the patient’s corneal anatomy caused the Prokera ring to be highly mobile on the eye and not stay in place. It had to be removed immediately.

Comments 0

Views 6

Is there a modifier code we can use to bill cataract surgery after a superficial keratectomy has been done without waiting the standard 90-day global period?

MAR 02, 2022 in Cornea, Ask the Expert, Modifiers, Cataract/Anterior Segment, Coding Top 10

Is there a modifier code we can use to bill cataract surgery after a superficial keratectomy has been done without waiting the standard 90-day global period?

Comments 0

Views 22

Collect self-pay fee for Intralase laser used during Intralase Enabled Keratoplasty (IEK)

MAR 02, 2022 in Cornea, Coding Top 10, Ask the Expert

Can we collect a self-pay fee from the patient for the Intralase laser used during Intralase Enabled Keratoplasty (IEK)procedure? The Intralase laser incision will be performed in our procedure room first and then the patient is brought to the operating room for the keratopl…

Comments 0

Views 4

Fact Sheet: Coding for XCELLERATE

DEC 07, 2021 in Cornea, Coding Updates

Fact sheet that helps you appropriately code for XCELLERATE, a self-retaining lyophilized membrane that promotes corneal wound healing. It naturally dissolves in 3-5 days but may be removed earlier if the patient’s condition improves.

Comments 0

Views 3309

CPT code for Meibomian Gland Expression

MAR 05, 2021 in Cornea, Ask the Expert, CPT

Q: Is there a code for meibomian gland expression?

Comments 0

Views 3721

Appropriate ICD-10 code for anterior corneal dystrophy

SEP 20, 2020 in ICD-10, Ask the Expert, Cornea

Which ICD-10 diagnosis code is appropriate for anterior corneal dystrophy?

Comments 0

Views 53

Applicable diagnosis code for rejection to corneal transplant

SEP 20, 2020 in Ask the Expert, ICD-10, Cornea

Our physician states the patient’s diagnosis is rejection to corneal transplant. Is there an applicable diagnosis code?

Comments 0

Views 8

Billing Multiple Layer AMT

JUN 24, 2020 in Cornea, Ask the Expert

Our physicians placed multiple layers of membrane with glue only, no sutures are involved. Is this considered CPT code 65780 Ocular surface reconstruction; amniotic membrane transplantation, multiple layers?

Comments 0

Views 382

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