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 84 results
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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

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 67

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 31

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 263

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 52

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 89

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 38

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 499

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 1425

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 3640

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 700

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 153

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 271

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 566

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 2219

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 979

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 270

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 467

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 667

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 147

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