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  1. Edmundo

    Wiki New to ophthalmology!!!!

    Hello Svail7! Yes, you can.
  2. Edmundo

    Wiki Annual eye exam billed with dry eyes

    Please reference this medical decision-making table when coding E/M. Best of luck in Ophthalmology! e-m-final-determination-table-2023-version-pdf (aao.org) Edmundo Gonzalez, CPC, COPC, OCS
  3. Edmundo

    Wiki Annual eye exam billed with dry eyes

    Hi Jennifer, It's a pleasure. Question 1. Usually when the patient is dilated, all 12 elements of the comprehensive exam (92004/92014) is documented - you will need to confirm that in the chart. If 3 or more elements are documented but less than 12, you may code CPT 92002/92012. If...
  4. Edmundo

    Wiki Comprehensive eye examination

    Hi @chriskane28 - It's a pleasure. Great question! Check out this informative fact sheet created by the American Academy of Ophthalmology. It goes over the key components of CPT 92004/92014. Fact Sheet for the Comprehensive Eye Visit Codes: 92004 and 92014 - American Academy of Ophthalmology...
  5. Edmundo

    Wiki 99204, 92250, 92133, 92020

    Hi @ncharba - It's a pleasure. You may be able to unbundle CPT 92250 & 92133 using the modifier 59, depending on the payer. Usage of the modifier 59 is rare but it does occur in some instances. Please review the article published by the American Academy of Ophthalmology. Unbundling 92250...
  6. Edmundo

    Wiki 92004 with 92015

    Hi @krisw7067 Yes, you may bill CPT 92004 with 92015 on the same day. These services are separately reported. Kindly, Edmundo Gonzalez, CPC, COPC, OCS
  7. Edmundo

    Wiki Complex Cataract surgery

    Hi @ambermeade Great question! According to the American Academy of Ophthalmology, these are the list of ICD10CM codes that are considered to be mature cataract: H25.21 Age-related cataract, morgagnian type (hypermature) right eye, H25.22 left eye, or H25.23 bilateral; H25.811 Combined forms...
  8. Edmundo

    Wiki Long term (current) use of hydroxychloroquine (Plaquenil)

    Hi Jodi, It's a pleasure! If the patient is coming in for drug monitoring, use ICD10CM Z51.81 as your primary for the E/M & Z79.899 (reporting hydroxychloroquine) as your secondary. Please also code the RA in your E/M. As for diagnostics, set Z79.899 as your primary to help support medical...
  9. Edmundo

    Wiki Aetna 92136

    Hi KCMable, 1st eye - 92136, (Anatomical modifier LT or RT) 2nd eye - 92136, 26, (Anatomical modifier LT or RT) Best of luck in Ophthalmology! Kindly, Edmundo Gonzalez, CPC, COPC, OCS
  10. Edmundo

    Wiki Risk table for MDM

    Hello! May I please get a copy of this too? | Ed.gon0001@gmail.com Kindly, Edmundo Gonzalez, CPC, COPC OCS
  11. Edmundo

    Wiki botox to eye muscle

    I agree, CPT 67345. Edmundo Gonzalez, CPC, COPC, OCS
  12. Edmundo

    Wiki Use of modifier 50 in ASC

    Hi LMO312, Great question! It varies when coding for professional or facility. Modifier 50 is appropriate when coding professional. Separate line items with RT/LT are appropriate when coding facility. For example: Patient X comes in for a bilateral YAG procedure. Professional - CPT 66821, 50...
  13. Edmundo

    Wiki New to ophthalmology!!!!

    Welcome to the ophthalmology family! You got this!🙌 Edmundo Gonzalez, CPC, COPC
  14. Edmundo

    Wiki Complex Cataract surgery

    Hello CBP2014! It's a pleasure. Great question! Determining a complex cataract case depends within your contractor. Please reference both these articles & confirm your jurisdiction - again guidelines vary. I'm in jurisdiction JH. One of the following below is what we consider a cataract case...
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