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 78 results
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Coding Top 10 - September 2021

SEP 22, 2021 in Retina, Oculofacial, Testing Services, ICD-10, Cataract/Anterior Segment, Exams, Glaucoma, Coding Top 10, Ask the Expert, Coding Updates

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

Comments 0

Views 222

One of our doctors is stating that we can charge the patient for the optiwave refractive analysis (ORA) when the ultrasound, CPT code 92136 isn’t done. Is this true?

SEP 22, 2021 in Cataract/Anterior Segment, Ask the Expert, Testing Services

One of our doctors is stating that we can charge the patient for the optiwave refractive analysis (ORA) when the ultrasound, CPT code 92136 isn’t done. Is this true?

Comments 0

Views 36

Confusion when finding the appropriate diagnosis code for reimbursement for CPT code 66982 Complex cataract extraction with IOL.

SEP 22, 2021 in Cataract/Anterior Segment, Ask the Expert

Confusion when finding the appropriate diagnosis code for reimbursement for CPT code 66982 Complex cataract extraction with IOL.

Comments 0

Views 55

When it comes to submitting billing, should I code the pars plana vitrectomy (PPV) first then 66982 Complex cataract extraction? In the case of the exchange PPV first then 66986?

SEP 22, 2021 in Cataract/Anterior Segment, Retina, Ask the Expert

When it comes to submitting billing, should I code the pars plana vitrectomy (PPV) first then 66982 Complex cataract extraction? In the case of the exchange PPV first then 66986?

Comments 0

Views 28

What is the CPT code for the removal of an anterior chamber implant?

SEP 22, 2021 in Glaucoma, Ask the Expert, Cataract/Anterior Segment

What is the CPT code for the removal of an anterior chamber implant?

Comments 0

Views 26

I am performing iris synechiolysis of adhesions during a cataract surgery. How should the claim be submitted?

SEP 22, 2021 in Cataract/Anterior Segment, Glaucoma, Ask the Expert

I am performing iris synechiolysis of adhesions during a cataract surgery. How should the claim be submitted?

Comments 0

Views 33

Due to a dense cataract, the IOL measurement was taken on CPT codes 92136 and then 76519. Can I bill both tests?

SEP 08, 2021 in Ask the Expert, Testing Services, Cataract/Anterior Segment

Due to a dense cataract, the IOL measurement was taken on CPT codes 92136 and then 76519. Can I bill both tests?

Comments 0

Views 68

Effective July 11, First Coast Service Options and Novitas Solutions Update Cataract Local Coverage Determination (LCD) Policies

JUL 09, 2021 in Cataract/Anterior Segment, Coding Updates

Effective July 11, First Coast Service Options and Novitas Solutions Update Cataract Local Coverage Determination (LCD) Policies

Comments 0

Views 358

Diagnosis Selection When Multiple Cataracts

MAY 13, 2021 in Ask the Expert, Cataract/Anterior Segment

The surgeon’s documentation lists mature/posterior subcapsular cataract (PSC) for the cataract. How would you recommend coding this? As a mature cataract or a PSC?

Comments 0

Views 90

Payment for Intra-operative Injection

MAY 13, 2021 in Cataract/Anterior Segment, Ask the Expert

Can a surgeon be paid separately when administering a retrobulbar block prior to cataract surgery?

Comments 0

Views 78

Additional Fees For Monovision IOL

MAR 05, 2021 in Ask the Expert, Cataract/Anterior Segment

Q: For patients choosing monovision as part of cataract surgery, extra calculation is necessary. Are we able to bill the patient for this service?

Comments 0

Views 156

Reduction in Payment for Higher Allowable Procedure

MAR 01, 2020 in Modifiers, Glaucoma, Cataract/Anterior Segment, Coding Updates, Coding Top 10, Ask the Expert

Question: When performing cataract surgery and goniotomy at the same session, I append modifier -51 to cataract surgery, as it has a lower allowable. However, our Medicaid plan has a higher allowable on the cataract surgery, so I append the goniotomy with modifier -51. We re…

Comments 0

Views 202

Coding Top 10: Frequency of Retina OCT, Frequency of Billing Fundus Photography and Superglue to Eye

MAR 01, 2020 in Testing Services, Exams, Cataract/Anterior Segment, Coding Top 10, Oculofacial, Ask the Expert, Glaucoma, Modifiers, Coding Updates

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The March coding selections include: Frequency of Retina OCT, Frequency of Billing Fundus Photography and Superglue to Eye

Comments 0

Views 2403

Dextenza Billing

DEC 18, 2019 in Cataract/Anterior Segment, Ask the Expert

Question: How do we bill for Dextenza when used with cataract surgery?

Comments 0

Views 1411

Unbundling Goniosynechialysis with Cataract Surgery

DEC 11, 2019 in Glaucoma, Cataract/Anterior Segment, Ask the Expert

Question: Is it appropriate to unbundle CPT code 65865 Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae, with cataract surgery?

Comments 0

Views 1920

Billing Cataract Surgery in Conjunction With iStent Inject

NOV 06, 2019 in Cataract/Anterior Segment, Ask the Expert, Glaucoma

Question: When our surgeon performs cataract surgery plus iStent inject on a Medicare Part B patient, how should the surgeon and the facility submit the claim?

Comments 0

Views 2327

Billing AC Tap in Post-operative Period

NOV 06, 2019 in Glaucoma, Cataract/Anterior Segment, Ask the Expert

Question: Are anterior chamber taps, billable in the post-operative period?

Comments 0

Views 247

IOL Master Performed After Ascan Billed

JUL 31, 2019 in CPT, Testing Services, Ask the Expert, Cataract/Anterior Segment

Question: We performed CPT code 76519 A-scan bilaterally on our patient and billed the first eye. The surgeon is now requesting CPT code 92136 IOL Master for the second eye. Can we bill this?

Comments 0

Views 572

Usage of miLoop in Cataract Surgery

JUL 30, 2019 in CPT, Ask the Expert, Cataract/Anterior Segment

Question: Does use of miLoop qualify cataract surgery as complex?

Comments 0

Views 1425

Unrelated Exam Same Day as Planned Surgery

JUL 30, 2019 in Ask the Expert, Cataract/Anterior Segment, Modifiers, Exams

Question: Our patient, who was scheduled to come today for a YAG Capsulotomy in the right eye, came in with a complaint of blurriness and flashes in the left eye. We did an exam of the left eye and performed the YAG in the right eye. How should we submit?

Comments 0

Views 352

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