tci E/M Coding Alert - 2015 Issue 12

Reader Question: Easily Identify E/M vs. Eye Codes

Question: I just started at an ophthalmology practice and am having trouble figuring out when to report an E/M code rather than eye exam/evaluation code. Can you explain the difference and when to use each one? For example, what would I report when a new patient presents complaining difficulty reading traffic signs? The ophthalmologist performs a comprehensive examination, including checking her visual acuity, gross visual fields, ocular mobility, retinas, and intraocular pressure. Pennsylvania Subscriber Answer: The general rule for CPT® codes is to pick the code that most clearly describes the service the ophthalmologist renders. If he is...

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