• Coding Top 10: iStent Implant with Lens Exchange, CPT Code for Removing an iStent


    Coding Top 10, February 2018

    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.

    The February coding top 10 selections include:

    1. Billable Services for Driver License 
      The Department of Motor Vehicles informed one of our patients that she needed to have a visual field performed due to a motor vehicle accident. The patient signed an Advance Beneficiary Notice and paid for the visual field the same day. Do I need to send a claim to her Medicare insurance?

    2. CPT Code for Orbital Fat Removal via Conjunctival Incision 
      What CPT code can I use for removal of prolapsing orbital fat through a small conjunctival incision?

    3. CPT Code for Removing an iStent 
      If the ophthalmologist needs to remove an iStent outside of the global period, how should we submit this?

    4. Visual Field Staging 
      When do we assign a stage to glaucoma: only upon visual field performance?

    5. Billing OCT and Visual Field Same Day 
      One of my physicians heard we no longer can submit glaucoma OCTs and visual fields on the same day. Is this true?

    6. Billing Medicaid Patients 
      Can we bill patients who have Qualified Medicare Beneficiary Medicaid?

    7. iStent Implant with Lens Exchange
      If we implant an iStent during a lens exchange, can we still bill the payer for it?

    8. Technicians Performing Sensorimotor Exam 
      CPT code 92060 Sensorimotor exam states that an ophthalmologist or orthoptist can provide this service. What about the doctor’s technician if it’s under his supervision?

    9. VEP Testing for Glaucoma 
      I noticed that, new in 2018, there is a Category III code 0464T Visual evoked potential, testing for glaucoma, with interpretation and report. Can we only use this code if the patient’s diagnosis is glaucoma, or can we use 95930 Visual evoked potential?

    10. Appropriate Modifier for Surgery in Global Period 
      Our ophthalmologist performed a YAG laser vitreolysis within the global period of a YAG capsulotomy (CPT code 66821). Should we append modifier -59 to CPT code 67031 YAG vitreolysis? The diagnoses are different.