Coding for Dry Eyes

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

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

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

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

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

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

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

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

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

Coding for Dry Eyes Punctum Plugs 68761 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.

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

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

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

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

Punctum Plugs CCI 68761 + 68440 (-59 ok) (Snip incision of lacrimal punctum) 68801 (-59 ok) (Dilate punctum) 68810 (-59 ok) (Probe nasolacrimal duct)

Punctum Plugs Doctor Order No Supervision Level Does not apply  

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  

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

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

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

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

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

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

Coding for Dry Eyes Meibomian Probe

Ocular Side Effects file://localhost/Users/alanhomestead/Documents/My Documents B 3-8-13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Topic Modules/Ocular SE Sys Med/Oc SE Aug 13.ppt