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  • About Our Coding Experts

    About Our Coding Experts

    Our expert staff have decades of combined experience, covering all aspects of coding and reimbursement.

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  • 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 28 results
    12
    Billing Consultation Codes When Medicare is Secondary
    MAY 13, 2021 in E/M, Ask the Expert
    The primary insurance is a commercial plan that recognizes consultation codes. Medicare Part B is the secondary insurance. Can we bill a consult code?
    • Comments 0
    • Views 119
    Billing Eye Visit Codes to Commercial Payers
    MAY 13, 2021 in Ask the Expert, E/M
    Medicare accepted eye visit code with medical diagnosis, but the commercial plan as secondary insurance, denied the claims. How do I proceed?
    • Comments 0
    • Views 209
    Practice Telemedicine Protocol
    MAY 13, 2021 in Ask the Expert, E/M, Telemedicine
    An evaluation of telemedicine protocol
    • Comments 0
    • Views 115
    Corneal Laceration - Coding for Ocular Trauma case study
    APR 20, 2021 in Trauma Coding, ICD-10, Exams, Ask the Expert, CPT, E/M
    First day on the job at a home improvement store, an 18-year-old cuts the metal band around layers of stacked wood. The metal band flipped lacerating his cheek to forehead, including eye on the left side of his face.
    • Comments 0
    • Views 349
    Canalicular Laceration - Coding for Ocular Trauma case study
    APR 20, 2021 in Exams, Trauma Coding, CPT, ICD-10, E/M, Ask the Expert
    Exam revealed right lower canalicular laceration from wire hidden in lawn.
    • Comments 0
    • Views 155
    Commotio Retina Involving Macula - Coding for Ocular Trauma case study
    APR 20, 2021 in Ask the Expert, CPT, E/M, ICD-10, Trauma Coding, Exams
    8-year-old nephew of retina specialist was hit in left eye with soccer ball. Immediately complained of decreased vision.
    • Comments 0
    • Views 154
    Prescription Definition for Medical Decision Making
    MAR 05, 2021 in Ask the Expert, E/M, Exams
    Q: Will refraction or contact lens prescription count as moderate for medical decision-making?
    • Comments 0
    • Views 522
    Moderate Decision Making for Medically Necessary Surgery
    MAR 05, 2021 in Exams, Ask the Expert, E/M
    Q: When any surgery is determined to be medically necessary, such as cataract surgery or entropion, but the patient defers surgery, are we still able to meet moderate medical decision-making?
    • Comments 0
    • Views 317
    Billing 99215 for Same Day Exam as Surgeon
    MAR 05, 2021 in E/M, Ask the Expert, Exams
    Q: If our physician determines a patient has a retinal detachment and refers the patient to a retina surgeon on the same day, should we submit 99215?
    • Comments 0
    • Views 191
    Billing CPT code 99058
    MAR 05, 2021 in Exams, Ask the Expert, CPT, E/M
    Q:We have never submitted CPT code 99058 Service(s) provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service for patients seen when our local hospital refers them. How should we submit?
    • Comments 0
    • Views 949
    16 Questions and Answers About New E/M Definitions and Guidelines
    DEC 23, 2020 in E/M, Ask the Expert
    Get clarification on new E/M guidelines effective Jan. 1 from questions answered by the American Medical Association and the Academy. For more information, visit aao.org/em.
    • Comments 0
    • Views 11232
    Countdown to new E/M requirements beginning Jan. 1
    DEC 14, 2020 in Ask the Expert, E/M
    Follow these steps to help your practice shore up any outstanding items before the evaluation and management (E/M) documentation requirements go into effect on Jan. 1. For more information, the Academy has continued education at aao.org/em.
    • Comments 0
    • Views 607
    Coding Top 10: Billing Irrigation for Chemical Injury, Audit Tool Applied to Eye Visit Codes, Complete Review of Systems When Not Pertinent to Exam
    DEC 08, 2020 in E/M, Ask the Expert, Coding Top 10, 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 1092
    Countdown to New E/M Requirements: Preparation for January 1
    DEC 01, 2020 in Exams, Ask the Expert, E/M
    The Academy has your implementation strategy for the new evaluation and management (E/M) changes, so that your practice is ready on Jan. 1. Use these steps to ensure your practice has a smooth transition. You can find further education at aao.org/em.
    • Comments 0
    • Views 645
    Example of risk factors for minor surgery
    NOV 06, 2020 in E/M, Ask the Expert
    Question: What is an example under risk of complications and/or morbidity or mortality of patient management of minor surgery with identified patient or procedure risk factors?
    • Comments 0
    • Views 919
    Do non-covered tests count in MDM
    NOV 06, 2020 in Exams, Ask the Expert, E/M
    Question: Is the refraction, Amsler grid, glare testing, etc., considered tests for amount and/or complexity of data to be reviewed an analyzed with the new E/M documentation criteria?
    • Comments 0
    • Views 436
    Artificial tears qualify as prescription medication
    NOV 06, 2020 in Ask the Expert, E/M
    Question: Under risk of complications and/or morbidity or mortality of patient, do artificial tears for the dry eye patient count as prescription drug management?
    • Comments 0
    • Views 330
    Countdown to New E/M Requirements: Medically Relevant History
    NOV 04, 2020 in Ask the Expert, Exams, E/M
    With the new requirements of evaluation and management (E/M) beginning Jan. 1, 2021, we can no longer keep documenting as we always have. So how do you begin making the change? These five steps will guide you on your journey.
    • Comments 0
    • Views 1374
    Billing for Smoking Cessation Counseling
    NOV 02, 2020 in E/M, Exams, Ask the Expert
    I was made aware there are two CPT codes for smoking cessation counseling. Are they appropriate for ophthalmologists to use?
    • Comments 0
    • Views 1011
    Billing Irrigation for Chemical Injury
    NOV 02, 2020 in E/M, Ask the Expert, Exams
    Our physician irrigated a patient’s eyes using the Morgan lens device after a chemical injury. Is this separately billable?
    • Comments 0
    • Views 299
    1-20 of 28 results
    12
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