Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., Rebecca Wartman, O.D.
From the January/February 2016 edition of AOA Focus, page 44-45.
As we enter the new year, it's important to be aware of new code changes. Note the deletions, revisions and reminders below:
1. Code deletion
CPT 97140 (provocative tests for glaucoma, with interpretation and report, without tonography) has been deleted. This code was deleted due to low utilization. Current Procedural Terminology (CPT) offers no guidance for what code to report in its place. As always, in selecting an appropriate CPT code to report, report the code that accurately identifies the service performed. If there is not a CPT code that accurately reports the service, report the unlisted procedure code.
2. Code revisions
CPT 92235 fluorescein angiography (includes multiframe imaging) with interpretation and report and CPT 92240 indocyanine-green angiography (includes multiframe imaging) with interpretation and report have been revised. CPT definitions for these services now clarify that these codes describe angiography of both eyes or one eye. A new code has been created for fluorescein angiography and indocyaninegreen angiography performed at the same patient encounter with interpretation and report, unilateral or bilateral. That code number was not yet made available at the time of publication.
3. Diagnosis codes reminder
Hundreds of new ICD-10 diagnosis codes went into effect on Oct. 1, 2016. Access an ICD-10 changes webinar and all of the AOA's ICD-10 resources at aoa.org/coding. For a listing of the new codes, purchase the newest codes at AOA Marketplace.
Use AOA member resources for coding assistance
AOA's Coding Experts also recommend utilizing AOA Coding Today, an online comprehensive database that contains information in real time for CPT, ICD-10 and Healthcare Common Procedure Coding System coding and research. The website is tailored specifically to optometry and assists doctors and staff in correct reimbursement and compliance, and has an easy-to-use code diagnosis ability based on region. Use AOA Coding Today as a free member resource to assist you immediately with your coding questions.
AOA speaks out for profession
The AOA is fully engaged in the CPT code development and revision process. The AOA is represented by Rebecca Wartman, O.D., (primary representative) and Harvey Richman, O.D., (alternate representative) at the American Medical Association's (AMA) CPT panel meetings. Douglas Morrow, O.D., AOA's former primary CPT representative, currently sits on the CPT panel. The panel meets three times a year to discuss the creation of new codes, revisions to current codes and whether codes should be deleted.
Ask the coding experts
If you have any questions regarding Medical Records and Coding, please submit them by using the Coding Experts Submission Form and one of our coding experts will be in contact with you.
Changes in coding and reimbursements worth knowing. Meanwhile, with the clock winding down on 2023, the AOA continues to press for Congress to act on reforms that would give doctors of optometry an annual, permanent inflationary Medicare payment tied to the Medicare Economic Index.
The federal government and private payers are heavily scrutinizing the use of modifier -25. When used appropriately, it can help to ensure that patients receive appropriate treatment and that doctors of optometry are reimbursed appropriately for their service. If you believe a claim that includes modifier -25 was inappropriately denied, follow appropriate criteria when appealing.