MAY 13, 2021
Billing Eye Visit Codes to Commercial Payers
Question: One of the commercial plans does not recognize eye visit codes with a medical diagnosis. We have multiple patient's claims being denied. This involves both primary and secondary claims. Some of the claims with Medicare primary and this commercial plan as secondary. Medicare accepted the eye visit code with medical diagnosis, but the commercial plan as secondary insurance, denied the claims. How do I proceed?
Answer: These scenarios are part of the indications when an Eye visit code can’t be submitted. Please see EyeNet®’s Sept 2019 Savvy Coder.