- 5 best practices for offering prompt-pay discounts
- New Demodex blepharitis codes available for optometrists
- Ask the Coding Experts
- The key to deflecting downcoding? Diagnosis code reporting
- 2025 code changes: What doctors of optometry need to know
- Introducing the new CMS G2211 code
- Coordination of benefits 3 takeaways for optometric billing practices
- Clearing up modifier confusion
- Payor Downcoding: What Is It and What Should You Do About It
- New noteworthy optometry codes
- Modifier -25: How to use it appropriately and avoid costly penalties
- 3 coding questions cracked
- CPT codes deleted in 2023—do you know what codes may be billed to replace them?
- Why Proper Documentation Is Vital
- Common coding questions answered
- How and when to code for social determinants of health
- Most asked coding questions: dilation
- What does COVID-19 PHE ending mean for telemedicine
- 2 points to keep in mind when patients decline dilation
- social determinants of health
- Can a doctor of optometry bill Medicare for a comprehensive eye exam and a procedure on the same day
- The future of audio-only reimbursement
- Coding conundrums solved
- 7 takeaways from the 2023 Medicare Physician Fee Schedule Final Rule
- Virtual check-in codes
- What your colleagues are asking about coding
- CMS releases 2023 Medicare PFS proposed rule
- Merit-based Incentive Payment System: What doctors should know
- Ask the coding experts
- Merit-based Incentive Payment System quality measures
- Coding for presbyopia eye drops
- Coding and contact lens safety
- CMS 2022 Medicare PFS decreases conversion factor sets new policy goals
- CMS releases information on Part B claims-based quality measure scoring for 2021
- Updated ICD-10 codes take effect October 1
- If it sounds too good to be true
- New EM codes
- What to do when a coding decision is made incorrectly
- 4 coding changes now in effect
- changes in 2021 to coding and documentation for evaluation and management services.
- AOA HPI provides coding benchmark data
- Appropriate use of modifier 25
- Changes on the horizon for evaluation and management services
- AOA Coding Experts gain AMA CPT appointments
- 2020 PFS changes for optometry
- 2020 updates to the ICD-10 code set
- Medicares virtual check-in codes
- The importance of accurate coding and contact lens safety
- coding for cognitive development test
- Medicare evaluation and management documentation and billing
- Coding and audits
- 5 coding queries cracked
- appropriate diagnosis code reporting
- Diagnostic code changes
- 4 coding conundrums clarified
- Where coding and coverage intersect
- Changes on the horizon for evaluation and management documentation and reimbursement
- New ICD-10 codes effective
- July-Aug17_Coding Q&As
- The ICD 10 code development process
- coding experts-billing for post-cataract glasses
- accurate coding for public health
- July Aug 2017 Coding Experts
- September Coding Experts
- CMS data collection on postoperative visits
- 3 solutions to common coding problems
- 3 coding changes doctors need to know
- Coding cases cracked
- New diabetes related diagnosis codes
- Get answers to your coding questions
- New ICD10 codes doctors need to know
- Be aware of changes for 2017 and beyond
- Common coding Qs answered
- Coverage indications limitations and medical necessity
- 4 tips for competing with online retailers
- Coding questions cracked
- Access online coding resource for AOA members
- What is the future of CPT coding
- CMS makes changes in how doctors revalidate Medicare enrollment information
- 5 coding changes and clarifications doctors need to know
- More ICD 10 coding Q&As
- Doctors of optometry could see a rise in labor costs under new federal overtime rule
- 4 tips for growing your practice
- HHS unveils proposed rule for new Quality Payment Program
- Ask the Coding Experts Comparative billing reports raise questions on glaucoma patient treatment and coding
- Ask the Coding Experts Modifier 24 and 25 usage
- ICD-10 coding QandAs October
- Ask the Coding Experts Chronic care management services
- ICD 10 transition So far so good
- CMS comparative billing reports What you need to know
- Ready resources for the ICD 10 rollout
- Coding Q&As
- Online payment option makes cents
- Modifiers for distinct procedural services
- Get a refresher on your public Open Payments data
- Final countdown Get answers to your ICD-10 coding questions
- AOA clarifies meaningful use rule on electronic order entry
- More ICD 10 coding QandAs
- Vision therapy coding
- Medicare claims and requests for additional documentation
- Coding QnAs May
- Referring ordering and form 8550
- Reporting code 92250
- One-year Medicare payment fix extends ICD-10 deadline
Global period data collection and possible future changes
November 6, 2018
CMS may consider revaluing the 10-day global procedures in the near future.
Excerpted from page 40 of the October 2018 edition of AOA Focus.
As the Coding Experts have previously reported, over the past several years the Centers for Medicare & Medicaid Services (CMS) has grappled with the appropriate valuation of surgical services, which contain multiple office visits in the post-operative global period. CMS is concerned that a greater number of post-surgical visits have been included than are actually delivered by the surgeon or co-managing provider during the 10-day (minor surgery) or 90-day (major surgery) global period.
On July 1, 2017, CMS began requiring doctors who practice with more than 10 practitioners and who practice in certain states (Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon or Rhode Island) to report CPT 99024 (postoperative follow-up visit) when the doctor provides a visit during the postoperative period for certain services. For doctors of optometry, this reporting would be done when the doctor is providing postoperative care to a patient after surgery. CMS only requires that the postoperative visits be reported with CPT 99024 for certain surgical services. Find a complete listing of the codes that trigger reporting in 2018.
CMS recently released data on the number of doctors who are complying with this requirement.
CMS estimates that there are 247 doctors of optometry who performed at least one of the 293 relevant global procedures and were affiliated with a tax identification number with 10 or more practitioners. Out of those doctors, approximately 158 reported the appropriate 99024 code (64% of the relevant doctors of optometry).
Through this data analysis, CMS has indicated that there is a very small number of postoperative visits reported using CPT code 99024 during 10-day global periods. CMS is considering whether this is an indication that many visits included in the valuation of 10-day global packages are not actually being furnished. Based on this analysis, CMS may consider revaluing the 10-day global procedures in the near future.
Doctors practicing in the states that are required to report and who have a practice with more than 10 practitioners should ensure that visits are being appropriately reported for all 10- and 90-day global procedures on the required codes. Codes that require this reporting include glaucoma surgery, cataract surgery, laser treatment of retina, removal of eyelid lesion, closure of tear duct opening and many more. All doctors of optometry should be aware of this effort and the early CMS findings as this will likely result in reimbursement changes in the near future.
Other important updates
Updated ICD-10 Codes
New ICD-10 codes went into effect on Oct. 1, 2018. A number of changes have been made that impact doctors of optometry, including the addition of new codes for malignant melanoma of the eyelids; paralytic ectropion of eyelids; mechanical lagophthalmos and more. The 2019 Codes for Optometry manual can be purchased from AOA Marketplace.
Corneal cross-linking coding
In the American Medical Association's (AMA) CPT coding guidance publication, CPT Assistant, information was included regarding the appropriate coding to report corneal cross-linking for both the procedure and the drug. CPT has clarified that Category III code 0402T, collagen cross-linking of cornea (including removal of the corneal epithelium and intraoperative pachymetry when performed), is reported for the operative procedure. However, when performed in the office of a doctor of optometry or another physician's office, "the supply of eye drops would be reported separately with code 99070," according to CPT Assistant. While this guidance was provided by AMA CPT, it was noted that coding for the procedure and the drug may vary based on payer.
More resources
AOA Coding Today is an online, comprehensive database that contains information in real time for CPT, ICD-10 and HCPCS coding and research. The website is tailored specifically to optometry, assists doctors and staff in correct reimbursement and compliance, and has an easy-to-use code diagnosis ability based on region. This exclusive member resource can assist you immediately with your coding questions.
If you have suggestions for how AOA can best support the coding needs of doctors of optometry, please contact Kara Webb, AOA's director for coding and regulatory policy, by email or call 703.837.1018.