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 86 results
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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 176

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 1182

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 81

Billing with -53 modifer

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

One of our surgeons performed a cataract surgery with a canaloplasty on the same day. The surgeon was not able to complete the canaloplasty due to the patient’s head tremors. She made multiple attempts but only about 30% of the canal was open and no further efforts were made…

Comments 0

Views 95

Appending modifier on bundled services

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

The patient had cataract surgery on the left eye (CPT code 66984 -LT) and a YAG laser capsulotomy on the right eye (CPT code 66821 -RT) on the same day. I know payment for the laser will be reduced by 50% as the second procedure, but do I need to append any modifier other th…

Comments 0

Views 126

Changes in CPT language for 99211

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

Has the CPT language for 99211 changed over the past few years?

Comments 0

Views 174

They’re Back: Target, Probe and Educate Requests for Records

OCT 20, 2021 in Regulatory News, Cataract/Anterior Segment

Target, Probe and Educate (TPE) is one of the many types of audits conducted by the Center for Medicaid and Medicare Services (CMS) requesting documentation.

Comments 0

Views 303

Cataract Documentation Checklist

OCT 13, 2021 in Regulatory News, Cataract/Anterior Segment

In this short video, Ravi Goel, MD presents a cataract surgery documentation checklist to prepare practices for Medicare's Target, Probe and Educate (TPE) audits.

Comments 0

Views 256

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 791

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 106

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 190

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 85

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 74

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 119

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 107

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 397

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 101

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 83

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 181

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 207

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