Jeffrey P. Restuccio – Optimizing Compliance and Maximizing Revenue

GDX/OCT Scanning Computerized Ophthalmic Diagnostic Imaging – SCODI

Jeffrey P. Restuccio – Optimizing Compliance and Maximizing Revenue

A COMPREHENSIVE LOOK AT CODING EYECARE

• CPT coding fundamentals
• HCPCS coding – G codes – S codes – V codes
• Contrast and comparison of the E & M codes vs. the eye exam codes
• The intermediate and comprehensive eye exams
• Overview of Evaluation and Management (E & M) guidelines
• What services can you offer? and You cannot report using the office visit codes
• How to choose the best insurance company and Employer in your area
• Which is the most likely audit you will have?
• What your EMR isn’t currently checking or gathering accurately
• How to
  • Think like an auditor
  • Maintain strict compliance with coding and optimal reimbursement
  • Train the providers and What are their responsibilities?

COMMON EYE PROCEDURES OVERVIEW

• GDX/OCT Scanning Computerized Ophthalmic Diagnostic Imaging – SCODI
• Co-Management and cataract surgery
• Fundus Photography
• Visual Field Examination
• Photography of the external eye
• Ophthalmic echography and biometry
• Coding for dry eye syndrome and punctal plugs
• Miscellaneous procedures

NEW AND IMPROVED ICD Advanced-10 CODING

• Added, Deleted, and 2018 Revised codes
• Degenerative Myopia
• Blindness
• Low vision
• What is disease specificity?
• Formal ICD-10 concepts for coding training
• Two codes are required and You can’t have just one.
• There are exceptions and “Gotchas”
• Keratoconus
• Pterygiums
• Amblyopia
• Glaucoma

CRITICAL TO REIMBURSEMENT PROCESS

• Information about the National Correct Coding Initiative (NCCI).
• Relative Value Units (RVU’s)
• Guidelines for Local Coverage Determination
• Global Days/Global fees
• The Bilateral Surgery Indicator

SURGICAL PROCEDURES IN THE OFFICE

• Codes to remove foreign bodies
• Repair codes
• Epilation
• Punctal Plug insertion
• Proper use of modifiers

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