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 often. Academy coding advice is based on current information. 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 114 results
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Coding Top 10 - March 2023

MAR 10, 2023 in Retina, Testing Services, Exams, CPT, Cornea, Pediatric/Strabismus, Coding Competency, Cataract/Anterior Segment, Modifiers, Coding Top 10, 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 405

Internal Subspecialty Referrals, New or Established

MAR 10, 2023 in Exams, Coding Competency, Ask the Expert

When the cataract specialist in our group practice refers a new patient to me, a retina specialist, can I bill the office visit as a new patient? Each physician in our practice utilizes primary ophthalmology and subspecialty taxonomies.

Comments 0

Views 57

Documentation Location for Activities of Daily Living

MAR 10, 2023 in Coding Competency, Ask the Expert, Exams, Cataract/Anterior Segment

For cataract surgery, where do we document the patient’s specific activity of daily living (ADL) that is affected?

Comments 0

Views 63

Eyelid Modifiers or Eye Modifiers

MAR 10, 2023 in Ask the Expert, Coding Competency, Oculofacial, Modifiers

What modifier(s) should we use when billing for CPT 11440 – “Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less” when the procedure is done on the upper…

Comments 0

Views 88

New Dry Eye Treatment

MAR 10, 2023 in Testing Services, Coding Competency, Cornea, Ask the Expert

Can iLux be billed with 0207T when it is a covered service? iLux is not automated but the description for 0207T states automated.

Comments 0

Views 44

Skin Cancer Screening

MAR 10, 2023 in Coding Competency, Ask the Expert

How do we bill skin cancer screenings?

Comments 0

Views 26

Atropine Therapy

MAR 10, 2023 in Exams, Pediatric/Strabismus, E/M, Ask the Expert, Coding Competency

How do we bill for atropine therapy?

Comments 0

Views 19

Who Documents the Order for Testing?

MAR 10, 2023 in Testing Services, Ask the Expert, Coding Competency

Can a scribe document the testing service that the physician orders under their log in? The documentation states, "written by (scribe’s name) acting as a scribe for (physician’s name)." Or is the physician required to login and order the test?

Comments 0

Views 56

Evaluation and Management Resources

MAR 09, 2023 in Ask the Expert, Coding Competency, E/M, Exams

I am a comprehensive ophthalmologist in a rural setting, and I only use Eye visit codes but would like to start using Evaluation and Management (E/M) codes. Where should I go to find resources on how to use E/M codes?

Comments 0

Views 79

Verify, Then Trust Technology

MAR 06, 2023 in Coding Competency, Ask the Expert, Testing Services

Learn about the common deficiencies in Electronic Health Records (EHRs), and how the verification process will help you to trust this essential technology.

Comments 0

Views 107

New vs. Established: Nuances for Ophthalmology Subspecialties

FEB 28, 2023 in Ask the Expert, Coding Competency

New vs. Established: Nuances for Ophthalmology Subspecialties

Comments 0

Views 203

Coding Top 10 - February 2023

FEB 03, 2023 in Retina, Oculofacial, Cataract/Anterior Segment, Coding Competency, Coding Top 10, Cornea, CPT

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

Comments 0

Views 658

YAG for Epithelial Ingrowth

FEB 02, 2023 in Ask the Expert, Cornea, CPT, Coding Competency

My physician uses a YAG laser to treat epithelial ingrowth on a patient. Would we bill the YAG procedure code of 66821 and the diagnosis of H18.891? Or should we be using the unlisted code 66999?

Comments 0

Views 54

Keratoptosthesis

FEB 02, 2023 in Cornea, CPT, Ask the Expert, Coding Competency

I perform combined surgery when the cornea is cloudy, and the retina surgeon needs to perform a vitrectomy. I begin by removing the patient's cornea and suturing in a temporary keratoprosthesis. The retinal surgeon then performs the vitrectomy. Afterwards, I cut all sutures,…

Comments 0

Views 48

Billing for 0207T

FEB 02, 2023 in Ask the Expert, Cornea, Coding Competency, Oculofacial, CPT

When our ophthalmologist performs Lipiflow, we bill our Medicare contractor the unlisted CPT because the Category III reimbursement does not cover the expense of the supplies to perform this service. Medicare paid with the unlisted code, other payers do not. Are we able to c…

Comments 0

Views 112

BAT for Cataract Surgery

FEB 02, 2023 in Coding Competency, CPT, Ask the Expert

Can physicians use a pen light with the phoropter as a brightness acuity tester (BAT)? We have a BAT but one of the new physicians thinks that the pen light is about the same as the medium setting on a BAT?

Comments 0

Views 125

Separate Fee Schedule for Self-Pay Patients

FEB 02, 2023 in CPT, Coding Competency, Ask the Expert

May a practice have separate fee schedules for commercial insurance vs. self-pay price?

Comments 0

Views 176

Coding Top 10 - January 2023

JAN 20, 2023 in Exams, Oculofacial, Coding Competency, Cataract/Anterior Segment, Modifiers, Ask the Expert, E/M, Coding Top 10, Retina, Testing Services, CPT

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

Comments 0

Views 567

Commercial Denial of -GA Modifier

JAN 20, 2023 in CPT, Coding Competency, Testing Services, Ask the Expert

We recently billed an OCT with -GA modifier, and it was denied by Blue Care Network Advantage plans. They state the -GA modifier is not needed, and we should delete it.

Comments 0

Views 56

Reimbursement for CPTs 66987 and 66988

JAN 19, 2023 in CPT, Cataract/Anterior Segment, Ask the Expert, Coding Competency, Glaucoma

Is there wRVU and reimbursement information from CMS for combo CPT codes 66987 and 66988?

Comments 0

Views 86

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