tci Outpatient Facility Coding Alert - 2017 Issue 11

Reader Question: Cataract Coding Face-Off: Physician Practice vs. Surgery Center

Question: I code for a surgery center and an associated physician clinic. Most of our patients are diagnosed with bilateral cataracts, but only come in for surgery on one eye at a time. In case of an audit, is it important that the facility claims match the clinic claims?   Florida Subscriber Answer: You should always be coding for the highest level of specificity, says Rhonda Buckholtz, CPC, CPCI, CPMA, CDEO, CRC, CHPSE, COPC, CENTC, CPEDC, CGSC, vice president of practice optimization at Eye Care Leaders. The coding guidelines for this situation say that when a patient presents...

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