Use V Codes to Report Follow-Up Visits

Question: If a patient receives treatment and the condition was resolved, which ICD-9 code should I report if the patient returns in six months for a follow-up visit? Answer: The most accurate way to code visits to follow up on treatment for a previous...

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Billing How-To: Should A Provider Change Tax IDs?

Despite disadvantages, a new tax ID is a must when physicians leave your group.

Question: One of our optometrists wants to stop billing under the group’s tax ID and start billing under his own tax ID. I’m concerned that doing so will confuse the insurance companies and slow down his income, even though he has personally called some to notify them of the change and the effective date. Some payers are now asking for new W9 forms. Is there an easy way to do it?

Answer: Your optometrist can change his tax ID at any time, but you must submit a new W9 to your payers, in addition to a letter explaining that he will no longer be practicing under the group’s tax ID.

Downside: Yes, the optometrist’s income will be slowed. You also run the risk that the payer’s enrollment department does not handle the paperwork properly. Other billers have reported instances of the income being paid to the old tax ID or not being paid at all. Claims can also be lost even though the correct paperwork has been submitted multiple times.

If your optometrist is currently part of a group, and he is leaving the group, he needs his own tax ID. Many legal issues will arise from this. For example, if he is staying in the same office suite, he will have to pay market rent for the offices and staff that he is using. When patients move between the old practice and his new practice, questions will arise about which patients are considered new and which are considered established patients.

Much of this will have to be determined by the legal structure that is set up as he leaves the group. This can be a much more complex change than it appears on the...

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Ophthalmology Coders: Does Old BB-Gun Injury Have Bearing on Coding?

The reason your patient is visiting is key. Question: We have a patient who came in for a routine eye exam, but reported retinal damage from a BB-gun incident six years ago. What would be the best way to code this? This is a new patient, and I do not h...

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Optometry Coding: Stop 92081-92083 Denials in Their Tracks

Record visual fields interpretation and report the right way. Visual fields are a compliance hot spot. Optometrists should use the visual field interpretation and report (I&R) to record what their thinking process was at that moment by recording any changes noticed, how the field compares to other testing like OCT (92135, Scanning computerized ophthalmic diagnostic imaging, [...] Related articles:

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Cataract Surgery Coding: When Optometrist Provides Postop Care

We’ve got the modifier you need when the ophthalmic surgeon passes the baton. Question: An ophthalmic surgeon performs cataract surgery, and then turns the patient over to the optometrist for postoperative management only. How should I code between the two providers? Do I need a modifier? Answer: If the ophthalmic surgeon turns the patient over to the [...] Related articles:

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  3. Cataract Removal Eye-Opener: 66984CPT 66984 is the number-one procedure performed in ASCs, according...

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Coding News Coding News – News about Coding 2009-11-30 23:00:02

Split Postoperative Cataract Care Question: An ophthalmic surgeon performs cataract surgery, and then turns the patient over to the optometrist for postoperative management only. How should I code between the two providers? Do I need a modifier? Washington Subscriber Answer: If the ophthalmic surgeon turns the patient over to the optometrist for all 90 days of postoperative care, the optometrist will report 66984 [...] Related articles:

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  3. Medical Coder’s Modifier 25 Checklist Append 25 with the greatest of ease … Appending...

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