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 70 results
1 2 3 4

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 53

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 45

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 131

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 192

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 2239

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 1246

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 1607

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 2021

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 230

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 542

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 1326

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 343

Billing Exams in the Global Period

JUL 08, 2019 in Modifiers, Cataract/Anterior Segment, Exams, Ask the Expert

Question: A patient 60 days into the global period for cataract surgery has been diagnosed with a post-vitreous detachment (PVD), which may or may not be related. The physician feels this should be billable. Should we append modifier -24?

Comments 0

Views 526

Surgeon Treating Patient in Co-management

JUL 08, 2019 in Exams, Cataract/Anterior Segment, Ask the Expert

Question: A patient is being co-managed for cataract surgery and has now returned to the surgeon for a related complaint. Is the surgeon able to bill for the exam?

Comments 0

Views 214

Referring Patient to Partner During Global Period

JUL 08, 2019 in Ask the Expert, Retina, Exams, Modifiers, Cataract/Anterior Segment

Question: Our patient is in the global period for cataract surgery, and it’s been determined she has cystoid macular edema (CME). We referred her to a retina specialist n our practice. Is the exam billable with modifier -24?

Comments 0

Views 294

Surgery Without Office Exam

JUN 10, 2019 in Ask the Expert, Exams, Cataract/Anterior Segment

Question: One of our surgeons is injured and unable to perform cataract surgery. Is another surgeon of the practice able to perform surgery without seeing the patient in the office?

Comments 0

Views 228

EUA During Cataract Surgery

JUN 10, 2019 in Cataract/Anterior Segment, Ask the Expert, Exams

Question: Our surgeon performed cataract surgery on a Down syndrome patient. During the surgery he performed an exam under anesthesia (EUA) due to the patients cognitive and emotional limitations. Previously, we have billed CPT code 92499 to bill the exam under anesthesia.…

Comments 0

Views 1040

Manual Break of Posterior Synechiolysis

MAY 07, 2019 in Cataract/Anterior Segment, Ask the Expert, CPT

Question: Our physician manually broke a posterior synechiolysis between iris and lens. Is there an existing CPT code that is best, or would we use an unlisted code?

Comments 0

Views 2213

Lysis of Adhesions Along with Cataract Surgery

MAY 07, 2019 in Ask the Expert, CPT, Cataract/Anterior Segment

Question: Am I able to submit for lysis of adhesions separately from cataract surgery, or would this qualify for CPT code 66982 Complex cataract surgery?

Comments 0

Views 1185

CPT Code YAG Laser for IOL Deposit

MAR 18, 2019 in Cataract/Anterior Segment, Ask the Expert, CPT

Question: A patient presented with deposits and pigment on the anterior surface of an IOL. The surgeon used a YAG laser. What is the appropriate CPT code to submit?

Comments 0

Views 809

1-20 of 70 results
1 2 3 4

Narrow Your Results

Select Code Type

Select Topic

Select Category

About Our Coding Experts

OUR SITES

FOLLOW THE ACADEMY