Cataract Surgery and Glaucoma Stents – Ophthalmology Management

Cataract surgery is frequently performed in conjunction with glaucoma stent procedures. In 2022, we have new CPT codes to describe these combination procedures. This article addresses the following questions: What glaucoma stent procedures are performed with cataract surgery? What are the new CPT codes? Is there reimbursement for the stent procedures without cataract surgery? What…

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Noridian Announces Widespread Service-Specific Probe Review for 66984

On October 20, 2015, Noridian (the Medicare Administrative Contractor for a large number of states in the Western US) announced that they are initiating a review of documentation related to CPT code 66984 in all states within their Jurisdiction E (JE).  The states in JE are California, Hawaii, Nevada, American Samoa, Guam, and the Northern…

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When ECP is your choice – Ophthalmology Management

When glaucoma medications fail or the patient cannot tolerate them, surgeons have various surgical procedures they can turn to — and then bill for. Here’s help with the latter task for one glaucoma surgery option when others have failed: endoscopic cyclophotocoagulation. This article addresses the following subjects: What is endoscopic cyclophotocoagulation? What are the indications?…

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How to code those complicated cataract surgeries – Ophthalmology Management

Cataract surgery is one of the most highly successful treatments in all medical history, with the cost-benefit equation to prove it. Further proof of my claim: Usually, all goes well. But when the rare complicated surgery occurs, the proper coding for it may involve office visits, testing, and a major or minor surgical treatment; additionally,…

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“Dropless” Cataract Surgery & Corneal Tissue – CMS clarification

On December 12, 2014, CMS released the January 2015 update to payment policies in the Hospital Outpatient Prospective Payment System (OPPS). Effective January 1, 2015, Transmittal 3150 contains two important payment policies for ophthalmologists. Corneal Tissue The transmittal reminds hospitals that corneal tissue is paid on a cost basis with HCPCS code V2785. It states:…

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Laser cataract coding and billing – Ophthalmic Professional

The process of coding and obtaining proper reimbursement for laser cataract surgery is complex enough to warrant a two-part article. In this first part, we focus on a simple question with a complex answer. The question: Who pays for the surgery and associated testing if we use the femtosecond laser in cataract surgery? Insurance companies…

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Your guide to correct YAG coding – Ophthalmology Management

Questions about Medicare rules for YAG laser capsulotomy (CPT 66821) still come up. Here are some that practices ask about the most. This article answers the following questions: What are the indications for YAG laser capsulotomy? What documentation is required in the medical record? What about repeat YAG procedures? Will Medicare cover YAG capsulotomy performed…

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Documentation for “Second” Eye Surgeries – Ophthalmic Professional

Most of us know how to properly document the functional complaints that justify the medical necessity for cataract and YAG capsulotomy. The same level of documentation applies to each eye. While that seems straightforward, patients may inadvertently not properly justify the need for the second eye surgery. Topics addressed in this article include: Improper documentation…

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