• Coding Top 10: Billing Corneal Puncture in Office, Balance Billing for Refractions and Excision of Eyelash


    Coding Top 10, February 2019

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    The Academy Coding Experts receive daily questions at coding@aao.org and icd10@aao.org. We are committed to providing accurate responses so that practices are confident in their billing and coding.

    Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The February coding selections include:

    1. Standing Orders Billed to Non-Medicare Payers 
      Does the insurance rule that physicians must examine the patient and then order any necessary tests apply to Medicare only or all payers?
    2. Repeat Laser for New Tear in Global Period
      If a patient has CPT code 67105 Laser for retinal tear and a new tear is found within the global period, can we bill the laser again?
    3. Global Period for Additional Lasers
      Do we restart the global period for additional laser treatment when billing CPT code 67145 Prophylaxis of retinal detachment, even though we don’t bill the additional laser?
    4. Foreign Body with Abrasion Noted
      We have a patient who had a corneal foreign body removed. An abrasion was also noted. Our physician wants to bill both ICD-10 codes: T15.02XA Foreign body of cornea and S05.02XA Corneal abrasion without foreign body. Could this cause a denial?
    5. Excision of Eyelash
      Our surgeon has to excise a lash that is ingrown into the lid. Is there a CPT code that is appropriate?
    6. Balance Billing for Refractions
      We performed a refraction on a Medicare patient. The secondary insurance has an allowable on the refraction charge. Can we balance bill the patient the difference between our charge and the secondary insurance allowable?
    7. Billing Corneal Puncture in Office
      We performed CPT code 65600 Multiple punctures of anterior cornea in the office setting. Our clearinghouse says that a hospitalization date must be listed on the claim. The patient was not an inpatient at the time. Is this service not allowed in the office?
    8. Correct Taxonomy Codes
      We are considering switching to the unique taxonomy code for our oculoplastic physician. Can you tell me if 2082S0099X – Allopathic & Osteopathic Physicians – Plastic Surgery is appropriate?
    9. Guidelines for ADL Forms
      For coding purposes, what are the guidelines on the questions we must ask for activities of daily living prior to cataract surgery?
    10. CPT Code for SITA-Fast Visual Field
      Is a SITA-Fast visual field CPT code 92083 or 92082?