The United States Government and the healthcare industry recoup significant amounts of money annually from healthcare providers as a direct result of medical record audits.  For many providers, the adoption of electronic record systems in recent years has only increased the complexity of being in compliance with an already complex system.  Providers continue to find it difficult and challenging to bill and code medical eye care. Billing insurance carriers for services are time intensive and require a thorough knowledge of appropriate and accurate coding. New guidelines and rules regarding CPT-4 and ICDA-10 coding further complicate the process. This year will be extremely challenging as Medicare/CMS finalized the first major change for outpatient office billing and coding since the 1990's. Significant changes in 'Evaluation and Management (E&M)' coding started in January 2021 and providers will need to need to learn and how to use these codes appropriately.  This course will provide a review of the necessary knowledgebase required for the proper documentation of optometric records, including required the new exam elements for 'Evaluation and Management', interpretation and report, modifiers and drawings.  Recommendations on steps to take when being audited will also be discussed.  As healthcare delivery transitions from a fee-for-service to a fee-for-value model, the question is no longer 'will I be audited' but 'when will I be audited.'  This course will prepare you for potential health care audits.

Course Code:



Richard Soden, O.D.



AOA Expiration Date:


Related News

AOA and AFOS: ‘Cut through the noise’ and empower licensed doctors of optometry to provide greater access to care to veterans

Eye care is the third-most requested health service by veterans at the VA—and doctors of optometry provide the majority of that care. Yet, as the Department of Veterans Affairs (VA) considers new national standards of practice for more than 50 health professions at its facilities, optometrists are making a winning case for expanding their role at an understaffed VA and are galvanizing against baseless attacks from organized medicine, ophthalmology and a few unbending legislators.

3 coding questions cracked

Does Medicare allow you to bill fundus photos and an optical coherence tomography on the same day for two different diagnoses? The answer to this question, and more, from the AOA’s experts.

Born to serve: Active duty paraoptometric professionals provide critical care

September is Paraoptometric Appreciation Month, celebrating optometric practice staff around the country. Two paraoptometric professionals who provide eye care as active-duty veterans in the United States Armed Forces share their stories.