Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., Rebecca Wartman, O.D.
Excerpted from page 45 of the January/February 2017 edition of AOA Focus.
AOA's experts share solutions to your coding conundrums.
Q. What is the code for Bear Track retinal pigment?
The diagnosis code would be "Dystrophies primarily involving the retinal pigment epithelium (H35.54)"
Q. It appears that some of the new ICD-10 codes are not included in the current PQRS specifications. What should I do?
The update to ICD-10 coding that occurred on Oct. 1 has affected Physician Quality Reporting System (PQRS) reporting for some measures. PQRS measure specifications for 2016 were not updated to include the coding changes that took place on October 1. CMS is currently in the process of developing a solution.
Q. Is there an online lookup for ICD-10 codes?
Yes, it can be found on the AOA Coding Today website.
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2017 coding resources now available
The 2017 AOA Codes for Optometry book with 2017 Express Mapping Card and AMA CPT Professional Edition are available at AOA Marketplace.
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Changes in coding and reimbursements worth knowing. Meanwhile, with the clock winding down on 2024, 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.