• Coding Top 10: PRP Global Period, Documenting Contraindication for Dilation, How to Code Corneal Melt

    Coding Top 10, May 2016

    Ask the Academy Coding Experts is an online resource for trusted responses to your coding questions.

    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 practices.

    May's coding questions highlight topics ranging from documenting contraindication for dilation to the global period for panretinal photocoagulation and ICD-10 code for corneal melt.

    1. CPT Code for Hyfrecation
      Our surgeon is performing a hyfrecation procedure on a patient with trichiasis. What CPT code should I use?

    2. ICD-10 Code for Chorioretinal Scars of the Macula
      I previously used ICD-9 code 363.32 for chorioretinal scars of the macula. Is there a similar one in ICD 10?

    3. ICD-10 Code for Corneal Melt
      What is the ICD-10 code for corneal melt?

    4. How to Document an Order for Testing Services
      What is the best way to document testing performed the same day on new patients? For established patients, the order is typically on the previous visit.

    5. Denial for Intravitreal Injection with Laser Procedure
      A commercial payer denies payment for CPT code 67028 Intravitreal injection when submitted with CPT codes 67210 Focal macular laser or 67228 Panretinal photocoagulation. The injection was made in the same anatomical site, but not through the same incision or surgical approach. Can you provide any assistance as to why they denied these claims?

    6. Endophthalmitis Diagnosis Appropriate for Intravitreal Injection
      When billing CPT code 67028 Intravitreal injection for endophthalmitis patients, what are my ICD-10 options?

    7. Submitting Visual Field and Glaucoma OCT Same Day
      Can we submit a visual field and glaucoma OCT on the same day?

    8. Modifier for Injection in Global Period of Laser
      Is there a postop period for lasers and injections? We have a patient who had a laser March 1 and then an injection on March 25.

    9. Documenting Contraindication for Dilation
      During the Academy’s Codequest course this year, I was taught that when billing an Eye visit code without dilation, you will need to document why the patient wasn’t dilated. We were told auditors tend to look for dilation when you submit a comprehensive exam. My physician disagrees, however, and said he was taught not to document a negative. Can you give me more info on this topic?

    10. Global Period for PRP
      I am confused about the global period for CPT code 67228 Panretinal photocoagulation. Has this changed from 90 days?