Coding for Dry Eyes 1. 92285 External ocular photography, documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography,

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Coding for Dry Eyes 1 Slide 2 92285 External ocular photography, documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography) (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography) 2 Slide 3 External ocular photography Indications, Diagnosis Codes, Frequency Medicare LCD Medicare LCD Noridian: No CGS: Yes WPS:No Novitas:No Palmetto: No 3 Slide 4 External ocular photography Indications, Diagnosis Codes, Frequency Non-Medicare Non-Medicare Every plan has own rules Clinical judgment May follow Medicare 4 Slide 5 External ocular photography Unilateral / Bilateral CPT: Silent Medicare: Bilateral, Payment same whether one or both eyes Non-Medicare: No universal rule, may follow Medicare 5 Slide 6 External ocular photography CCI 92020(-59 ok) 99211(-59 ok) 6 Slide 7 External ocular photography Interpretation and report Yes Doctor Order Yes Supervision Level General 7 Slide 8 Coding for Dry Eyes Lab 83861 Microfluidic analysis $23.58 (WA) TearLab Osmolarity System www.tearlab.com www.tearlab.com Waived test Must have certificate of waiver 8 Slide 9 Coding for Dry Eyes Lab Certificate of Waiver $150 for 2 yr (WA) Medicare co-payments & deductibles do not apply 9 Slide 10 Coding for Dry Eyes Lab Touch Scientific Lactoferrin MicroAssay System by Corneal Science Moderate complexity test License $450 per 2 year + training 10 Slide 11 Coding for Dry Eyes Punctum Plugs 68761 Closure of the lacrimal punctum; by plug, each -Bill same for all types (Herrick, SmartPlug), all materials (collagen, silicone, etc). all materials (collagen, silicone, etc). -Supply of plug bundled by Medicare; non-Medicare may pay. non-Medicare may pay. 11 Slide 12 Punctum Plugs Indications, Diagnosis Codes, Frequency Medicare LCD Noridian: No CGS: No WPS:No Novitas:Yes Palmetto: No 12 Slide 13 Punctum Plugs Indications, Diagnosis Codes, Frequency Non-Medicare Every plan has own rules Clinical judgment May follow Medicare 13 Slide 14 Punctum Plugs Surgical Report Not a coding requirement, for Medical-Legal. Pre-printed form with check boxes. Sample upon request. 14 Slide 15 Punctum Plugs Unilateral / Bilateral Medicare & Non-Medicare: Payment is per puncta, not per eye. 15 Slide 16 Punctum Plugs CCI 68761 + 68440(-59 ok) (Snip incision of lacrimal punctum) 68801(-59 ok) (Dilate punctum) 68810(-59 ok) (Probe nasolacrimal duct) 16 Slide 17 Punctum Plugs Doctor Order No Supervision Level Does not apply 17 Slide 18 Punctum Plugs Modifiers 4 Plugs 68761-E1 left upper lid 68761-E1 left upper lid 68761-E2-51left lower lid 68761-E2-51left lower lid 68761-E3-51right upper lid 68761-E3-51right upper lid 68761-E4-51right lower lid 68761-E4-51right lower lid 18 Slide 19 Punctum Plugs Modifiers 2 Plugs 68761-E1 left upper lid 68761-E3-51right upper lid 51 = Multiple procedures 19 Slide 20 Punctum Plugs Consent Form -Not a coding requirement. -Medical-Legal document. -Optional, unless liability insurer requires. 20 Slide 21 Punctum Plugs Global Period Medicare 10 days, follow-up visit paid after 10 th day post- op. Non-Medicare Varies, 0 to 15 days. 21 Slide 22 Punctum Plugs Payment -100% of 1st procedure, 50% of subsequent procedures. -Important: bill 100% of U&C for all procedures. 22 Slide 23 Punctum Plugs Great billing summary: Lacrimedics.com 23 Slide 24 Coding for Dry Eyes LipiFlow Paul Jensen OD, Renton/Bellevue 24 Slide 25 Coding for Dry Eyes Meibomian Probe 25 Slide 26 Ocular Side Effects file://localhost/Users/alanhomestead/Do cuments/My Documents B 3-8- 13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Topic Modules/Ocular SE Sys Med/Oc SE Aug 13.ppt file://localhost/Users/alanhomestead/Do cuments/My Documents B 3-8- 13/Adventures 11-3-12/O - S/Presentations/Repository of My PowerPoints/1 Topic Modules/Ocular SE Sys Med/Oc SE Aug 13.ppt 26