Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., Rebecca Wartman, O.D.
From the March 2016 edition of AOA Focus, page 43.
AOA's Coding Experts share solutions to your ICD-10 coding conundrums.
Were the Current Procedural Terminology (CPT) procedure codes impacted by the ICD-10 transition?
When ICD-10 codes replaced ICD-9 codes on Oct. 1, 2015, it did not impact how you report CPT and Healthcare Common Procedure Coding System (HCPCS) codes, including CPT/HCPCS modifiers for physician services. While ICD-10 codes have expanded detail, including specification of laterality for some conditions, you should continue to follow CPT and Centers for Medicare & Medicaid Services (CMS) guidance when you report CPT/HCPCS modifiers for laterality.
Is it possible for my practice to create a super bill for ICD-10, or is the code set too complex?
CMS has noted that practices may continue to create super bills that contain the most common diagnosis codes used in their practice. However, CMS cautions that super bills cannot provide all possible code options for many conditions.
What is the ICD-10 equivalent of the ICD-9 code V58.69 long-term (current) use of other medications?
Z79.899 other long-term (current) drug therapy.
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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.