Coding Top 10: Payment for Intra-operative Injection , Practice Telemedicine Protocol, Billing Consultation Codes When Medicare is Secondary

Get trusted answers to your coding questions from the Academy’s coding experts, so you can bill and code with confidence. The May coding selections include:

1. Payment for Intra-operative Injection
   Can a surgeon be paid separately when administering a retrobulbar block prior to cataract surgery?
2. Diagnosis Selection When Multiple Cataracts
   The surgeon’s documentation lists mature/posterior subcapsular cataract (PSC) for the cataract. How would you recommend coding this? As a mature cataract or a PSC?
3. Practice Telemedicine Protocol
   An evaluation of telemedicine protocol.
4. Patient Status When Billing Different Payers
   Does the routine vision exam reset the new patient clock so today’s medical exam can be billed as a new patient exam?
5. Billing Tests for Inpatient Exams
   If I see inpatients (hospital or emergency department) and bring in my own portable B-Scan or handheld camera, do I submit 92250 or 76512?
6. Billing Eye Visit Codes to Commercial Payers
   Medicare accepted eye visit code with medical diagnosis, but the commercial plan as secondary insurance, denied the claims. How do I proceed?
7. Billing Consultation Codes When Medicare is Secondary
   The primary insurance is a commercial plan that recognizes consultation codes. Medicare Part B is the secondary insurance. Can we bill a consult code?
8. Billing Corneal Hysteresis More Than Once
   Can corneal hysteresis be billed again after an intervention such as an SLT or starting new medication?
9. External Surgeon Using Laser
   A physician outside of our practice asked to use our laser to perform selective laser trabeculoplasty (SLT) on her patients. Although we have reached out to our malpractice carrier for potential concerns, are there billing issues that need addressed?
10. Documentation Rules for Physicians and Non-Physician Practitioners
    I’ve read that an ophthalmologist does not have to redocument information in the chart note, but does that also apply to our physician assistant (PA)?