1. Coding for Dry Eyes

2. Coding for Dry Eyes
92285 External ocular photography, documentation of medical progress
(eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)

3. External ocular photography
Indications, Diagnosis Codes, Frequency
Medicare LCD
Noridian: No
CGS: Yes
WPS: No
Novitas: No
Palmetto: No

4. External ocular photography
Indications, Diagnosis Codes, Frequency
Non-Medicare
Every plan has own rules
Clinical judgment
May follow Medicare

5. External ocular photography
Unilateral / Bilateral
CPT: Silent
Medicare: Bilateral, Payment same whether one or both eyes
Non-Medicare: No universal rule, may follow Medicare

6. External ocular photography
CCI
92020 (-59 ok)
99211 (-59 ok)

7. External ocular photography
Interpretation and report
Yes
Doctor Order
Supervision Level
General

8. Coding for Dry Eyes Lab 83861 Microfluidic analysis $23.58 (WA)
TearLab Osmolarity System
Waived test
Must have certificate of waiver

9. Coding for Dry Eyes Lab Certificate of Waiver $150 for 2 yr (WA)
Medicare co-payments & deductibles do not apply

10. Coding for Dry Eyes
Lab
Touch Scientific Lactoferrin MicroAssay System by Corneal Science
Moderate complexity test
License $450 per 2 year + training

11. Coding for Dry Eyes Punctum Plugs
Closure of the lacrimal punctum; by plug, each
-Bill same for all types (Herrick, SmartPlug),
all materials (collagen, silicone, etc).
-Supply of plug bundled by Medicare;
non-Medicare may pay.

12. Punctum Plugs
Indications, Diagnosis Codes, Frequency Medicare LCD Noridian: No CGS: No WPS: No Novitas: Yes Palmetto: No

13. Punctum Plugs Indications, Diagnosis Codes, Frequency Non-Medicare
Every plan has own rules
Clinical judgment
May follow Medicare

14. Punctum Plugs Surgical Report
Not a coding requirement, for Medical-Legal.
Pre-printed form with check boxes.
Sample upon request.

15. Punctum Plugs Unilateral / Bilateral Medicare & Non-Medicare:
Payment is per puncta, not per eye.

16. Punctum Plugs
CCI
68440 (-59 ok) (Snip incision of lacrimal punctum)
68801 (-59 ok) (Dilate punctum)
68810 (-59 ok) (Probe nasolacrimal duct)

17. Punctum Plugs
Doctor Order No
Supervision Level
Does not apply

18. Punctum Plugs Modifiers 4 Plugs 68761-E1 left upper lid
68761-E2-51 left lower lid
68761-E3-51 right upper lid
68761-E4-51 right lower lid

19. Punctum Plugs Modifiers 2 Plugs 68761-E1 left upper lid
68761-E3-51 right upper lid
51 = Multiple procedures

20. Punctum Plugs Consent Form -Not a coding requirement.
-Medical-Legal document.
-Optional, unless liability insurer requires.

21. Punctum Plugs Global Period Medicare
10 days, follow-up visit paid after 10th day post-op.
Non-Medicare
Varies, 0 to 15 days.

22. Punctum Plugs
Payment
-100% of 1st procedure, 50% of subsequent procedures.
-Important: bill 100% of U&C for all procedures.

23. Great billing summary: Lacrimedics.com
Punctum Plugs
Great billing summary: Lacrimedics.com

24. Coding for Dry Eyes
LipiFlow Paul Jensen OD, Renton/Bellevue

25. Coding for Dry Eyes
Meibomian Probe

26. Ocular Side Effects
file://localhost/Users/alanhomestead/Documents/My Documents B /Adventures /O - S/Presentations/Repository of My PowerPoints/1 Topic Modules/Ocular SE Sys Med/Oc SE Aug 13.ppt