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 74 results
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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 264

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 61

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 58

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 139

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 527

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 685

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 196

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 395

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 313

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 89

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 396

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 256

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 483

Return Exams for Corneal Rehab Prior to Surgery

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

Question: Patients return for multiple corneal rehabilitation therapies due to contact lens wear with our optometrist once cataract surgery has been determined medically necessary by one of the surgeons in the practice. Are these exams billable?

Comments 0

Views 76

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 227

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 462

Oxervate Training

JUL 31, 2019 in Exams, Cornea, Ask the Expert

Question: When prescribed Oxervate for neurotrophic keratitis, the patient is required to return for training and care of vials. Can we bill insurance for the training, which is performed by the technician, if we have an order?

Comments 0

Views 117

CPT Code for Swabbing Cornea

JUL 30, 2019 in CPT, Cornea, Ask the Expert

Question: Our physician frequently swabs an area of the eye and sends the sample to be cultured. The closest CPT code I see is 65430 Scraping of cornea, diagnostic, for smear and/or culture. However, its is not scraping, so I am unsure if we should submit.

Comments 0

Views 1103

Billing for Injection Related to Pterygium Surgery

JUL 08, 2019 in Cornea, Ask the Expert

Question: For the purpose of disrupting the vascular supply to the pterygium to prevent further growth and to reduce any potential damage to the cornea during the excision, our surgeon wants to inject mitomycin C first, followed by excision at another date. What is billable…

Comments 0

Views 171

Billing Serum Tears

JUL 08, 2019 in Ask the Expert, Cornea, CPT

Question: Is the office preparation of serum tears billable to insurance?

Comments 0

Views 1088

1-20 of 74 results
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