Is your Facility Abreast with these Changes in for Medical Coding?

Is your Facility Abreast with these Changes in for Medical Coding?

The Healthcare industry at the beginning of 2017 has been hit by sudden regulatory changes in the form of CPT codes for certain billing procedures in Optometry specialty.  Changes in Current Procedural Terminology (CPT) will mark the introduction of the 22nd release of CPT code changes, which will see a few additions, cancellations, and adjustments made to the current list.

The updates in the CPT codes for ophthalmology and optometry practices will change the way you report fluorescein angiography and retinal repair. This makes it important for both ophthalmology and optometry practices to refresh and update themselves with code changes, and also look into the fact that their in-house billers are abreast with it. However, if they are not competent enough, you always have the option of allocating the services to an offshore medical coding and billing company.

Let us take a look at the coding changes that have come in to effect this year.

Look out the Changes to ‘1 or More’ Retinal Repair

Previously, when a retinal repair detachment is repaired, 67101, is charged once, irrespective of the number of sessions performed. In any case, now CPT has expelled the designation for 1 or more session from 67101. Since 67101 is likewise the parent code of 67105, the update will affect both 67101 and 67105.

The following is a breakdown of how the two codes should be applied now:

  • 67101: Repair of retinal detachment, including drainage of sub-retinal liquid when performed; cryotherapy.
  • 67105: Photocoagulation

The change would imply that CMS may now permit practices to report numerous code units for more than one session; in any case, no coverage decision have been issued up to this point which clarifies the catalyst behind expelling at least 1 session from the code descriptors.

Angiography Codes are Bilateral now

CPT 2017 has likewise updated two angiography codes clarifying that the codes apply for both unilateral and bilateral procedures as follows:

  • 92235: Fluorescein angiography (incorporates multi-outline imaging) with elucidation and report, unilateral or bilateral.
  • 92240: Indocyanine-green angiography (incorporates multi-frame imaging) with elucidation and report, unilateral or bilateral.

This code change if not applied appropriately can lead to cut in repayment for ophthalmologists. Since, modifier 50 (Bilateral procedure) or modifiers LT (Left side) and RT (Right side) can be attached to 92235 and 92240 when billing respectively, it permits collecting higher payments for bilateral administrations. If the code changes go through as demonstrated, it is likely that you will just report one unit of 92235 or 92240 even when you perform the angiography benefit on both eyes.

Additional Changes:

  • 0444T – Initial arrangement of a medication eluting ocular insert below one or more eyelids, including fitting, training and insertion, unit or bilateral.
  • 0445T – Subsequent placement of a drug-eluting ocular insert under one or more eyelids, including re-training, and removal of existing insert, unilateral or bilateral.
  • 0446T – Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training.

Deletion Changes:

  • 0289T – Corneal incision in the donor cornea made utilizing a laser, in arrangement for penetrating or lamellar keratoplasty (Listed independently with addition to code for essential system)
  • 92140 – Provocative tests for glaucoma, with interpretation and report, without tonography.

Revised Codes:

  • 0333T – Visual evoked potential, screening of visual sharpness, automated with report.

In any case, it ought to be noticed that the updates in ophthalmology and optometry CPT codes are based on the preparatory list of code modification, and changes may happen even after the new codes are being used. If you want your Optometry practice to streamlined with the new codes, aligning your services with an experienced medical billing and coding organization will help a lot in terms of faster reimbursements, without you being worried about the coding updates.

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