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Coding for Dry Eyes 1. 92285 External ocular photography, documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography,

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Presentation on theme: "Coding for Dry Eyes 1. 92285 External ocular photography, documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography,"— Presentation transcript:

1 Coding for Dry Eyes 1

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

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

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

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 5

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

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

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

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

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

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). all materials (collagen, silicone, etc). -Supply of plug bundled by Medicare; non-Medicare may pay. non-Medicare may pay. 11

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

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

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

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

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

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

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

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

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

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

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

23 Punctum Plugs Great billing summary: Lacrimedics.com 23

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

25 Coding for Dry Eyes Meibomian Probe 25

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


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