Researching codes can take time. The Academy provides easy access to the tools physicians and staff need to submit a claim successfully and save time.
Two important tips:
Biometry Fact Sheet
Cataract Documentation Checklist
- The No. 1 rule in coding is identifying the payer. Whether commercial or federal, each payer can and does have its own rules.
- The No. 2 rule is don't apply one payer’s rules, or perceived rules, to all other payers
Clinical Laboratory Improvement Amendments (CLIA) Application for Certification
Correct Coding Initiative Edits
- 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.
- In this interview, Julia Lee, JD talks about the American Academy of Ophthalmology information and resources available to help you prepare for and pass a Cataract audit.
Evaluation and Management Codes
Guidelines for Billing Medicare Beneficiaries When Using the Femtosecond Laser
History & Physical
- Version 29.2 effective July 1, 2023.
Please use the 2023 Q1 Edits Files until CMS posts the 2023 Q3 Edits Files.
Meibomian Gland Dysfunction (MGD) and Dry Eye Disease (DED)
MIGS Fact Sheets
Modifier Reference Guides
Optiwave Refractive Analysis (ORA)
Preauthorization Check List
- Find decision trees, quick reference guides and key features of new CCI edits effective Oct 1. at www.aao.org/icd10.
Premium IOLs – A Legal and Ethical Guide to Billing Medicare Beneficiaries
Refraction Fact Sheet
- Medicare Advantage Plans, Commercial insurance and Medicaid plans often require preauthorization of exams, tests and surgeries. Make sure you are capturing all the necessary components by using this checklist [PDF]
Telemedicine Fact Sheet
VF-8R Visual Functioning Questionnaire
- For an overview of the No Surprises Act as well as links to advocacy and educational resources visit the Surprise Billing webpage
Medicare Part B Essentials
Advance Beneficiary Notice
Comparative Billing Reports
Entries in Medical Records: Amendments, Corrections and Addenda
- Note: Effective January 1, 2021 CMS requires all practices to use an updated version of form CMS-R-131, known as the Advance Beneficiary Notice or ABN. New expiration date 06/30/2023.
- Related article: "How to Use the ABN, 2020 Edition".
Reference: CMS Change Request 8105
(PDF), which updates the CMS Program Integrity Manual
(PDF) (Pub. 100-08), chapter 3, section 220.127.116.11.
Best practices complete the medical record in real time. However, for that unique case where a correction or addendum must be made, CMS stresses the following:
- Clearly and permanently identify any amendment, correction or delayed entry as such.
- Clearly indicate the date and author of any amendment, correction or delayed entry.
- Don’t delete, but instead, clearly identify all original content.
For paper medical records:
- Making corrections, in keeping with these principles, generally entails using a single line strike-through so the original content is still legible.
- The author of the alteration must sign and date the revision.
- Amendments or delayed entries must also be signed and dated by the author upon entry.
For electronic medical records:
- Amendments, corrections and delayed entries must be distinctly identified as such.
- The record must provide a reliable means of clearly identifying the original content, the modified content, and the date and author of each modified record.
Changes that do not comply with the above requirements must be disregarded in an audit, just as unsigned entries are.Items and Services Not Covered Under Medicare
Local Coverage Determination Policies (LCD)
Medicare Carrier Jurisdiction and Website Addresses
Postoperative Visit Reporting
- CMS document that supports your communication to the patient on non-covered exam, tests and surgeries.
- CMS is tracking number of postop visits actually reported on several surgical codes from a select set of practices. Visit www.aao.org/99024 for details.
Additional coding resources can be found in the Academy Store