"Optometry" Articles


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How to Properly Assign ICD-10-CM Codes for Pain

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Pain is a common diagnosis among all specialties so it should not be surprising to find there are 162 ICD-10-CM codes for reporting it and over 80 mentions in the ICD-10-CM Official Guidelines for Coding and Reporting which describe when certain types of pain should be reported and how the codes should be sequenced.

Comparison of Add-On Code Guidelines

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Add-on codes are codes that are not intended to be reported alone. They are reported with another primary procedure to identify that additional services have been provided in conjunction with that primary procedure. Generally, they include the words “List separately in addition to code.” Interestingly, there are some differences in the instructions/guidelines regarding the use of these codes in the CPT® codebook, the NCCI Policy Manual, and on the CMS website. This article outlines the differences between each of these.

New Communication Technology-Based Services (CTBS) Codes for Nonphysicians

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Medicare continues to expand the number of services provided via technology. There are some interesting new codes for nonphysician practitioners (NPPs) (e.g., psychologists, physical therapists) that became effective on January 1, 2021. Communication Technology-Based Services (CTBS), also known as virtual check-ins, describe specific short provider-patient communications which are initiated by the patient.

ICD-10-CM 2021 Codes for your Specialty

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7. Diseases of the eye and adnexa (H00-H59) Code:            Description: H18.501        Unspecified hereditary corneal dystrophies, right eyeH18.502        Unspecified hereditary corneal dystrophies, left eyeH18.503        Unspecified hereditary corneal dystrophies, bilateralH18.509        Unspecified hereditary corneal dystrophies, unspecified eyeH18.511        Endothelial ...

ICD-10-CM 2021 Codes for your Specialty

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19. Injury, poisoning and certain other consequences of external causes (S00-T88) Code:            Description:S20.213A      Contusion of bilateral front wall of thorax, initial encounterS20.213D      Contusion of bilateral front wall of thorax, subsequent encounterS20.213S      Contusion of bilateral front wall of thorax, sequelaS20.214A      Contusion of ...

ICD-10-CM 2021 Codes for your Specialty

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20. External causes of morbidity (V00-Y99) Code:            Description:V00.031A       Pedestrian on foot injured in collision with rider of standing electric scooter, initial encounterV00.031D       Pedestrian on foot injured in collision with rider of standing electric scooter, subsequent encounterV00.031S       Pedestrian on foot injured ...

Incident To

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Just about any large clinic you visit will have non-physician practitioners, or NPPs. These will include physician assistants, nurse practitioners, and clinical nurses for example. Practices and clinics can bill under the NPPs if they are credentialed with the payer, but the reimbursement is only 85% of the fee schedule. There ...

Stay out of Trouble — Understand the Qualified Medicare Beneficiary (QMB) Program

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To assist low-income Medicare beneficiaries, CMS created the Qualified Medicare Beneficiary (QMB) program; a Medicaid benefit which pays for Medicare deductibles, coinsurance, or copays for any Medicare-covered items and services for Medicare Part A, Part B, and Medicare Advantage (Part C). Providers/suppliers are prohibited from billing premiums and cost sharing to Medicare beneficiaries who are enrolled in QMB.

Are NCCI Edits and Modifiers Just for Medicare?

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The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...

ICD-10-CM Official Coding and Reporting Guidelines Updated for COVID-19

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The ICD-10-CM Official Coding and Reporting Guidelines have just been updated to include COVID reporting. Additional information beyond the previously released interim guidelines are included. These are the rules that should be followed for claims submission. The notice states that this is for April 1, 2020 through September 30, 2020.


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