• Coding Top 10: Injection Same Day as Cataract Surgery, Glaucoma Drainage Device, Billing Exam for Separate Complaint Implant After Failed TCP


    Coding Top 10, September 2020

    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.

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

    1. Injection Same Day as Cataract Surgery
      Can CPT code 67028 Intravitreal injection for diabetic retinopathy be billed for the same eye during cataract surgery?

    2. ABN Usage for Dual-Eligible Patients
      We have a patient who qualifies for Qualified Medicare Beneficiary (QMB). Are we able to use an Advance Beneficiary Notice (ABN) for a lesion removal?

    3. Glaucoma Drainage Device Implant After Failed TCP
      I’m performing an Ahmed tube implantation with patch graft within the global period of a failed transscleral cyclophotocoagulation. What CPT code and modifier is appropriate?

    4. Appropriate ICD-10 code for anterior corneal dystrophy
      Which ICD-10 diagnosis code is appropriate for anterior corneal dystrophy?

    5. Applicable diagnosis code for rejection to corneal transplant
      Our physician injected a patient with Jetrea for vitreomacular adhesion. I am confirming we submit three units.

    6.  ICD-10 Code for Inferior Oblique Overaction
      Our physician states the patient’s diagnosis is rejection to corneal transplant. Is there an applicable diagnosis code?

    7. Dry Eye Diagnosis for Epilation
      Our physician performed epilation with a primary diagnosis of dry eyes; however, we have not seen this diagnosis attached to this procedure before. Is this payable?

    8. Billing DWEK
      My surgeon states she performed DWEK. I am unsure what CPT code we should be using.

    9. Billing Exam for Separate Complaint 
      Our physician saw an established patient complaining of red and itchy eyes. The Diagnosis is allergic conjunctivitis, and abrasion was found that required debridement. Can we bill the exam and the procedure?

    10. Unrelated Exam Same Day as Planned Surgery
      Our patient, who was scheduled to come today for a YAG Capsulotomy in the right eye, came in with a complaint of blurriness and flashes in the left eye. We did an exam of the left eye and performed the YAG in the right eye. How should we submit?