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 81 results
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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 123

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 26

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 74

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 24

Congratulations to OCS and OCSR Designees

DEC 08, 2021 in Modifiers, Cornea, Pediatric/Strabismus, Cataract/Anterior Segment, Coding Updates, CPT, Exams, Glaucoma, Testing Services, ICD-10, Oculofacial, Coding Competency, Retina

Individuals who who have passed the Ophthalmic Coding Specialist and/or Ophthalmic Coding Specialist Retina exams.

Comments 0

Views 380

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 800

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 2598

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 673

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 142

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 166

Billing Corneal Hysteresis

MAR 01, 2020 in Cornea, CPT, Ask the Expert, Coding Updates, Coding Top 10

Question: Our practice just acquired equipment for corneal hysteresis. Can you tell me the appropriate CPT code to bill?

Comments 0

Views 467

Billing Punctal Plugs for Medicare

DEC 18, 2019 in Modifiers, Ask the Expert, Cornea

Question: How should I bill punctal plugs for Medicare patients? We always bill the Eye visit code with modifier -25, along with 68761 -RT and 68761 -LT, however Medicare is no longer processing the claim.

Comments 0

Views 1776

Separate Billing of Photrexa with Corneal Cross-linking

DEC 18, 2019 in Cornea, Ask the Expert

Question: When performing corneal cross-linking (CXL), do payers allow for separate billing of Photrexa?

Comments 0

Views 908

Billing Plugs to Commercial Payer

DEC 11, 2019 in Ask the Expert, Cornea

Question: While Medicare bundles punctal plugs into the insertion code, I thought commercial payers pay separately, however A4263 for silicone, is being denied. Is there another code we should bill?

Comments 0

Views 252

Dry Eye Diagnosis for Epilation

NOV 06, 2019 in ICD-10, Oculofacial, Cornea, Ask the Expert

Question: Our physician performed epilation with a primary diagnosis of dry eyes; however, we have not seen this diagnosis attached to this procedure before. Is this payable?

Comments 0

Views 457

Billing DWEK

NOV 06, 2019 in Ask the Expert, CPT, Cornea

Question: My surgeon states she performed DWEK. I am unsure what CPT code we should be using.

Comments 0

Views 573

Corneal Culture in Facility

NOV 06, 2019 in Ask the Expert, Cornea

Question: Our surgeon performed CPT code 65430 Scraping of cornea, diagnostic, for smear and/or culture in the ASC. I do not have a facility fee amount for this service. Are we allowed to bill for this in a facility?

Comments 0

Views 140

Intrastromal Injection CPT Code

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

Question: Our doctor performed an intrastromal corneal injection. Would CPT code 66030 Injection, anterior chamber of eye (separate procedure) medication be appropriate?

Comments 0

Views 1111

Suture Removal Under Anesthesia

SEP 10, 2019 in Cornea, Pediatric/Strabismus, Ask the Expert

Question: During the post-operative period of a corneal laceration repair, our surgeon performed an exam under anesthesia because of the patient’s due to poor vision, as well as, removed sutures. Is it appropriate to bill 92019 EUA, limited and 15850 Removal of sutures under…

Comments 0

Views 802

Billing Exam for Separate Complaint

SEP 10, 2019 in Cornea, CPT, Ask the Expert, Exams

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 581

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