Ophthalmic Coding Specialist

An established patient presents for an exam with the chief complaint of a red irritated eyelid. The diagnosis is blepharitis. The patient also has diabetes and recently received a comprehensive eye exam. What should the diagnosis for today's exam be? - Answer- Blepharitis only. The primary diagnosis should relate to the chief complaint. A 64 year old patient has cataract surgery. Now, at age 65, the patient obtains post cataract glasses. Is this a covered benefit? - Answer- Yes, HCPCS code V2020 Frames, purchases. What is the correct code to use when removing a rust ring using the slit lamp? - Answer- CPT code 65222 Removal of foreign body, external eye; corneal, with slit lamp. When coding Evaluation and Management services, what is indicative of a moderate level of risk? - Answer- 1. Minor surgery with identified risk factors. 2. Elective major surgery with no identified risk factors. 3. Prescription drug management Prior to inserting punctal plugs, what documentation should be noted in the medical record? - Answer- 1. Complaint indicating dry eye symptoms such as burning, excessive tearing, sensitive to light, etc. 2. Evidence that other methods of treatment have proven unsuccessful. 3. Documentation of tear/glad deficiency or a Schirmer tear test. The correct CPT code when inserting collagen punctal plugs is? - Answer- CPT code 68761 Closure of the lacrimal punctum; by plug, each. True or False- All punctal procedures are payable per puncta. - Answer- False. Only CPT code 68761. Closure of the lacrimal punctum; by plug, each, is payable puncta. All other lacrimal procedures are payable per eye. True or False- Glare testing, brightness acuity testing, and potential acuity measurement, are separately payable. - Answer- False. These tests are included, but not countable elements of an exam. Besides the patient's health/vision insurance, what other payers may be responsible for an ophthalmic exam? - Answer- Workers Compensation, home owner insurance, and automobile insurance. True or False- Category 3 codes such as 0099T Implantation of intrastromal corneal ring segments, are for new technology. As such they are not assigned an allowable or a global period until there is a payer specific coverage policy. - Answer- True