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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Coding Top 10 - November 2022

NOV 14, 2022 in Coding Competency, Coding Top 10, Pediatric/Strabismus, Retina, Trauma Coding, Exams, Cataract/Anterior Segment, Testing Services, Oculofacial, Ask the Expert

The Academy's coding experts answer the top coding questions from the annual meeting.

Comments 0

Views 372

Possible Ruptured Globe

NOV 14, 2022 in Ask the Expert, Trauma Coding, Coding Competency

Our retina surgeon took a patient to surgery for a possible ruptured globe. The operative note states there was no ruptured globe, that the patient has a history of trauma with iridodialysis and persistent hypotony. The procedure consisted of inspection of the globe as well…

Comments 0

Views 32

Does National Government Services Allow Splitting Single-Use Vials of Botox?

NOV 14, 2022 in Ask the Expert, Coding Competency

We are seeing more botulinum toxin patients on the same day; there are opportunities to have three patients share a vial and only bill a small amount of wastage. After reviewing single-use coding, multiuse coding and blepharospasm documents as well as the NGS Medicare billin…

Comments 0

Views 19

Exam Between Cataract Surgeries

NOV 13, 2022 in Coding Competency, Cataract/Anterior Segment, Exams, Ask the Expert

A patient has cataract surgery on their right eye and comes into the office the next day for their first postoperative appointment. During this appointment, the surgeon planned to go ahead with cataract surgery for the left eye. Can this visit be billed as an evaluation and…

Comments 0

Views 68

Diagram of Botox Injection Sites

NOV 13, 2022 in Ask the Expert, Coding Competency

Does the physician get paid for drawing the area where Botox is injected?

Comments 0

Views 29

Coding Coach Versus Payer Policy

NOV 13, 2022 in Coding Competency, Retina, Ask the Expert

During cataract surgery, the patient's capsule ruptured due to weak zonules. The IOL could not be implanted. What is the best procedure code for this?

Comments 0

Views 29

Unable to Implant Intraocular Lens (IOL)

NOV 13, 2022 in Coding Competency, Ask the Expert, Cataract/Anterior Segment

During cataract surgery, the patient's capsule ruptured due to weak zonules. The IOL could not be implanted. What is the best procedure code for this?

Comments 0

Views 24

How to Perform Internal Chart Audits in 10 Steps

NOV 11, 2022 in Exams, Modifiers, Coding Competency, Ask the Expert, Testing Services

These steps will help you initiate your audit and see you through the entire process from identifying audit targets to implementing a plan to prevent the discovered deficiencies.

Comments 0

Views 154

5 Co-Management Coding Tips

NOV 08, 2022 in Ask the Expert, Cataract/Anterior Segment, Coding Competency

Five tips to help you understand and implement correct co-management coding and documentation principles.

Comments 0

Views 385

Determining the Need for YAG Laser Capsulotomy

OCT 28, 2022 in Cataract/Anterior Segment, Coding Competency, Ask the Expert

Following the release of the Centers for Medicare & Medicaid Services’ (CMS’)comparative billing report (CBR) in September 2022, the Academy received questions about how to correctly code and bill for the services listed in the CBR. Use this checklist to ensure appropriate d…

Comments 0

Views 511

Documentation Deficiencies in Diagnostic Testing Services

OCT 26, 2022 in Coding Competency, Ask the Expert, Testing Services, Coding Updates

As a result of the comparative billing report released by the Centers for Medicare & Medicaid Services (CMS) last month, the American Academy of Ophthalmic Executives® has received many questions about how to correctly code and bill certain services.

Comments 0

Views 298

Cataract Surgeries Can Be Complex, Coding Doesn’t Have to Be

OCT 26, 2022 in Ask the Expert, Coding Competency, Cataract/Anterior Segment

As a result of the comparative billing report released by the Centers for Medicare & Medicaid Services (CMS) last month, the American Academy of Ophthalmic Executives® has received many questions about how to correctly code and bill certain services.

Comments 0

Views 335

Coding Top 10 - AAO 2022

OCT 20, 2022 in Coding Top 10, Cataract/Anterior Segment, Oculofacial, Retina, Ask the Expert, Testing Services, Coding Competency, Glaucoma, Exams, Pediatric/Strabismus

The Academy's coding experts answer the top coding questions from the annual meeting.

Comments 0

Views 466

Screening Tests

OCT 20, 2022 in Coding Competency, Testing Services, Ask the Expert

We have a physician who states all screening tests are not covered by Medicare and thus billable to the patient. We obtain an advance beneficiary notice (ABN) for OCTs prior to cataract surgery and file with a –GA modifier. Is this correct?

Comments 0

Views 66

Designated Health Services

OCT 20, 2022 in Ask the Expert, Coding Competency

What ophthalmic procedure codes are categorized as designated health services (DHS) by CMS?

Comments 0

Views 36

Chalazion With Kenalog Injection

OCT 20, 2022 in Coding Competency, Ask the Expert, Pediatric/Strabismus, Oculofacial

One of our doctors would like to treat chalazion with Kenalog injection. Do you know the proper code we should be using?

Comments 0

Views 91

Unknown Diagnosis

OCT 19, 2022 in Ask the Expert, Coding Competency

What diagnosis should we use when we are not sure of the diagnosis?

Comments 0

Views 42

Information about CMS’s recent Comparative Billing Report

OCT 19, 2022 in Coding Competency, Ask the Expert, Cataract/Anterior Segment

Where can we find more information on the Centers for Medicare & Medicaid Services (CMS) Comparative Billing Reports?

Comments 0

Views 69

CMS Releases Comparative Billing Reports on Cataract surgery

SEP 22, 2022 in Cataract/Anterior Segment, Ask the Expert, Coding Competency

Are you an outlier for cataract surgery and related services? Facilitated by the contractor RELI group, the Centers for Medicare & Medicaid Services has issued a comparative billing report (CBR) on Medicare Part B claims from Jan. 1 to Dec. 31, 2019 for three key metrics.

Comments 0

Views 2593

Coding Top 10 - September 2022

SEP 20, 2022 in Pediatric/Strabismus, Ask the Expert, Oculofacial, Exams, Coding Top 10, Cataract/Anterior Segment, Retina, Testing Services, Trauma Coding, Coding Competency, 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 536

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