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.
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Noridian Reports Cataract Documentation Failure Rates

JUN 07, 2022 in Cataract/Anterior Segment, Coding Competency, Ask the Expert

Cataract surgery continues to be one of the most common surgeries performed, and because of this, remains a top audit target for all payers.

Comments 0

Views 518

Coding Top 10 - June 2022

MAY 31, 2022 in CPT, Cataract/Anterior Segment, Coding Updates, Diabetes, Ask the Expert, Testing Services, Exams, Oculofacial, ICD-10, Retina, Glaucoma, Coding Top 10, Modifiers

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

Comments 0

Views 569

Coding Top 10 - May 2022

APR 22, 2022 in ICD-10, Exams, Ask the Expert, Coding Updates, Glaucoma, Coding Competency, Retina, Coding Top 10, Modifiers, CPT, Cataract/Anterior Segment, 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 1207

New Light Adjustable IOL Coding and Billing

APR 22, 2022 in Cataract/Anterior Segment, Coding Top 10, Coding Competency, Ask the Expert

Can you offer any insight on the most appropriate way to bill the light adjustable IOL, RxSight? Would V2787 be an appropriate code since this seems to function most like a toric lens?

Comments 0

Views 116

Coding Top 10 - April 2022

MAR 31, 2022 in Coding Competency, Modifiers, Coding Updates, Glaucoma, Ask the Expert, Pediatric/Strabismus, Cataract/Anterior Segment, CPT, ICD-10, Exams, Oculofacial, Retina, Coding Top 10

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

Comments 0

Views 482

92136 vs 76519

MAR 30, 2022 in Cataract/Anterior Segment, Coding Top 10, Ask the Expert

When we perform optical biometry, we occasionally do not get the axial length (AL) due to the cataract but can get the remaining measurements. We perform ultrasound/immersion only for the AL. Is it more appropriate to charge 92136 or 76519?

Comments 0

Views 102

Does This Support Modifier -59?

MAR 30, 2022 in Modifiers, Cataract/Anterior Segment, Ask the Expert, Coding Top 10

A physician performed complex cataract surgery 66982 OS on a patient and in the same session performed a 67005 OS. The op note reads: “One strand of vitreous was seen inferior-nasally so the anterior vitrectomy instrument was used to remove it.” Does this documentation sup…

Comments 0

Views 97

Diabetes and Cataracts

MAR 30, 2022 in Cataract/Anterior Segment, Coding Top 10, Ask the Expert

Several ICD-10 codes for diabetes include “with cataract”. Do they also apply to secondary cataracts? Is E11.36 appropriate to code when the physician documents that the patient has diabetes mellitus and secondary cataracts, but does not document the connection?

Comments 0

Views 82

Complex cataract removal - what is the correct coding?

MAR 15, 2022 in Ask the Expert, Coding Top 10, Cataract/Anterior Segment

Complex cataract removal - what is the correct coding?

Comments 0

Views 118

How many units should be billed?

MAR 15, 2022 in Trauma Coding, Ask the Expert, Coding Top 10, Coding Competency, Cataract/Anterior Segment

The treating physician gave an injection for endophthalmitis, vancomycin 1mg J3370 and ceftazidime 2 mg J0713. How many units should be billed?

Comments 0

Views 53

Coding Top 10 - March 2022

MAR 03, 2022 in Coding Top 10, Coding Updates, Pediatric/Strabismus, Glaucoma, Coding Competency, ICD-10, Cataract/Anterior Segment, CPT, Modifiers, Exams, Oculofacial, Ask the Expert, Retina

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

Comments 0

Views 965

Assistance with how to code 66982 and 65875

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

Could you please assist us on how to code 66982 and 65875. I see under 66982 Complex cataract surgery that 65875 Severing adhesions posterior synechiae, are bundled. Is it appropriate to append modifier –59 to unbundle?

Comments 0

Views 272

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

CPT Code and ICD-10 code for anterior capsulotomy for capsular himosis

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

We have a patient that needs an anterior capsulotomy for capsular himosis. Is the best CPT code for this 66999 Unlisted procedure, anterior segment of eye? What is an appropriate ICD-10 code?

Comments 0

Views 184

Coding Top 10 - January 2022

JAN 26, 2022 in Glaucoma, Coding Updates, Cataract/Anterior Segment, Ask the Expert, Exams, Retina, Coding Top 10, ICD-10

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

Comments 0

Views 1347

Submit claim for bilateral capsulotomy on Medicare Part B patient

JAN 26, 2022 in Cataract/Anterior Segment, Ask the Expert, Coding Top 10

Bilateral capsulotomy is performed on a Medicare Part B patient. How should the claim be submitted?

Comments 0

Views 112

Injection code for Duxyu used during cataract surgery

JAN 24, 2022 in Cataract/Anterior Segment, Coding Top 10, Ask the Expert

Our surgeon will begin using Duxyu during cataract surgery. The facility will bill for the drug. Is there an injection code for the surgeon to submit?

Comments 0

Views 80

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 365

Coding Top 10 - November 2021

NOV 04, 2021 in Glaucoma, Cataract/Anterior Segment, Ask the Expert, Coding Updates, Exams, Pediatric/Strabismus, Coding Top 10, ICD-10

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

Comments 0

Views 1345

Billing based on exam time

NOV 04, 2021 in Ask the Expert, Cataract/Anterior Segment, Glaucoma

I have several patients with Parkinson's disease/diplopia. I'm trying different powers of Fresnel prisms to try to reduce their diplopia. The exams sometimes take over an hour. How can I bill these visits since the extended exam code, 99354, is no longer allowed? Can I bill…

Comments 0

Views 118

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