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 34 results
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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 565

Pop Quiz: Billing for New vs. Established Patients

MAY 31, 2022 in Ask the Expert, Coding Competency, Exams

Whether you are starting your own practice, joining a group practice, acquiring patients from another practice or opening a new office location across town, a practice transition will create situations in which it will be important to know if a patient is considered new or e…

Comments 0

Views 253

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 1246

Eye Visit Codes for Inpatient Setting

APR 22, 2022 in Ask the Expert, Coding Top 10, Coding Competency, Exams

Can the Eye Visit codes only be used in the outpatient setting and not in the inpatient setting?

Comments 0

Views 103

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 134

Punctal Plug Supply Billing

APR 22, 2022 in Cornea, Coding Competency, Coding Top 10, Ask the Expert

Are we able to bill patients directly for the lacrimal plugs due to Medicare bundling them with the plug placement procedures?

Comments 0

Views 122

Outpatient Office Visit During Inpatient Stay

APR 21, 2022 in Exams, Coding Top 10, Coding Competency, Ask the Expert

We recently had a patient sent to us from our local hospital. We coded the office visit with E/M code 99204 and billed for fundus photos, CPT 92250. Both the office visit and the photos were denied by Medicare, which said the place of service is inconsistent with the procedu…

Comments 0

Views 90

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 496

Unified Program Integrity Contractor (UPIC) Audit

MAR 30, 2022 in Ask the Expert, Coding Competency, Coding Top 10

Could you advise me on how to move forward with a UPIC audit?

Comments 0

Views 101

Interpretation and Report

MAR 30, 2022 in Coding Competency, Ask the Expert, Coding Top 10

Do I have to create a separate interpretation for OCT-RNFL or may I state “see OCT” in my plan?

Comments 0

Views 97

Reimbursement for Dry Eye Test

MAR 29, 2022 in Coding Top 10, Coding Competency, Ask the Expert

What is the Medicare reimbursement for the dry eye test Inflammadry (83516)?

Comments 0

Views 89

Claim denials with the diagnosis H35.413 for Lattice Degeneration of Retina, Bilateral

MAR 15, 2022 in Coding Top 10, Ask the Expert, Retina, Coding Competency

Claim denials with the diagnosis H35.413 for Lattice Degeneration of Retina, Bilateral

Comments 0

Views 119

If a contact lens is stuck and the patient is unable to remove it, can you charge a foreign body removal code? Also, is an eyelash considered a foreign body?

MAR 15, 2022 in Exams, Ask the Expert, Coding Top 10, Coding Competency

If a contact lens is stuck and the patient is unable to remove it, can you charge a foreign body removal code? Also, is an eyelash considered a foreign body?

Comments 0

Views 126

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 55

Evaluation and Management Documentation for Glaucoma Suspect

MAR 15, 2022 in Ask the Expert, Coding Top 10, Coding Competency, Testing Services, Exams

A patient is a glaucoma suspect and has chronic dry eyes. The visual fields ordered and performed were suspicious for disease progression. The plan is for patient to follow up in 1-2 months with repeat visual field. What level evaluation and management (E/M) does the documen…

Comments 0

Views 132

Billing Medicare for Surgery in an Ambulatory Surgery Center

MAR 15, 2022 in Ask the Expert, Coding Top 10, Coding Competency

If our patient is in a skilled nursing facility (SNF) I just want to confirm that we cannot bill for surgery in an ambulatory surgery center (ASC) due to consolidated billing.

Comments 0

Views 82

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 972

I have a physician who would like to bill for an A-scan only when treating for myopia management in children. What is the appropriate CPT code?

MAR 02, 2022 in Coding Competency, Ask the Expert, Coding Top 10, Pediatric/Strabismus

I have a physician who would like to bill for an A-scan only when treating for myopia management in children. What is the appropriate CPT code?

Comments 0

Views 64

Information on billing HCPCS code V2627

MAR 02, 2022 in Coding Top 10, Ask the Expert, Pediatric/Strabismus, Coding Competency

I would like some information on code HCPCS code V2627. Does billing for this code includes all follow ups for the next 90 days? Can a physician bill for an office visit or is this included in the billing code as well?

Comments 0

Views 142

Modifiers to append for payment on additional treatments

MAR 02, 2022 in Coding Top 10, Modifiers, Coding Competency, Ask the Expert

A physician performs CPT code 65810 Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection multiple times on different days for ocular hypertension following a surge…

Comments 0

Views 122

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