• 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.

    All Payers

    Two important tips:
    • 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
    Audit information
    Biometry Fact Sheet
    Cataract Documentation Checklist [VIDEO]
    • 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.
    Clinical Laboratory Improvement Amendments (CLIA) Application for Certification
    Co-management
    Correct Coding Initiative Edits
    • Version 28.3 effective October 1, 2022.
    Evaluation and Management Codes 
    Guidelines for Billing Medicare Beneficiaries When Using the Femtosecond Laser
    History & Physical
    ICD-10 Resources
    • Find decision trees, quick reference guides and key features of new CCI edits effective Oct 1. at www.aao.org/icd10.
    Meibomian Gland Dysfunction (MGD) and Dry Eye Disease (DED)
    MIGS Fact Sheets
    Modifier Reference Guides
    Optiwave Refractive Analysis (ORA) 
    Preauthorization Check List
    • 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]
    Premium IOLs – A Legal and Ethical Guide to Billing Medicare Beneficiaries
    NPI Locators
    Refraction Fact Sheet
    Surprise Billing
    • For an overview of the No Surprises Act as well as links to advocacy and educational resources visit the Surprise Billing webpage
    Telemedicine Fact Sheet
    VF-8R Visual Functioning Questionnaire

    Medicare Part B Essentials

    Advance Beneficiary Notice
    • 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".
    Comparative Billing Reports
    Entries in Medical Records: Amendments, Corrections and Addenda
    Reference: CMS Change Request 8105 (PDF), which updates the CMS Program Integrity Manual (PDF) (Pub. 100-08), chapter 3, section 3.3.2.5.

    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:
    1. Clearly and permanently identify any amendment, correction or delayed entry as such.
    2. Clearly indicate the date and author of any amendment, correction or delayed entry.
    3. 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
    • CMS document that supports your communication to the patient on non-covered exam, tests and surgeries.
    Local Coverage Determination Policies (LCD)
    Medicare Carrier Jurisdiction and Website Addresses
    Postoperative Visit Reporting
    • 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.
    Taxonomy Codes
    • Learn about subspecialty taxonomy codes and how to report them.

    Coding Module

    Additional coding resources can be found in the Academy Store