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32 Cards in this Set
- Front
- Back
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codes for All levels of encounters/exams •
• Ophthalmic materials, supplies (HCPCS codes) |
CPT exam
codes)represent specific exam descriptions, procedures, surgery |
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codes for Procedures in addition to the exam
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(CPT
procedure codes)represent specific exam descriptions, procedures, surgery |
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codes for Diagnoses/diseases
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(ICD-9 codes)
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What does CPT stand for
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CPT= Current Procedural Terminology
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Two options for CPT codes (what #S do the codes begin w/?)
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92--- codes and 99--- codes
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what cpt codes are the opthalmology codes?
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92 codes
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can the 92 codes also be used to bill for a medical exam
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yes (and a visual exam)
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how many times a year can you bill a 92 code for vision
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1
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a 92 code intermediate exam must include how many exam elements (which much include 2 specific things)
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at least 7 exam
elements • Must include lids and adnexa |
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a 92 code comprehensive exam must include how many exam elements (which much include 2 specific things)
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need at least 8 exam
elements • Must include EOM and CF |
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T or F: you can bill a 92 code comprehensive exam for maintaining same therapy as
last year |
False: Must be initiating or changing therapy of some
kind |
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What CPT codes are for evaluation and management
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99--- codes. Codes for
exams/procedures involving all parts of the body |
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how many options/levels are there for 99 codes?
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10
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Whats they big deal about medicare and guidelines?
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Medicare guidelines are the standard by
which all other insurance providers follow |
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Key Elements in determining level of
service/exam: |
1. History
• 2. Examination (its content) • 3. Medical-Decision Making |
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as a group, what determines
determine the level of HISTORY in the medical record |
The CC, HPI, ROS and PFSH
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New Patient
requires what 3 key components |
History ,Exam, Decision
Making |
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Established patient
requires at least how many of the key components (History, exam, decision making) |
2of 3
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ICD 9 codes are for what?
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Diagnosis - code must support the need for
test |
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Can NOT bill ______ and ______ on same day
(at UABSO) |
GDx ,visual field
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Pachymetry for CCT can be billed (how many times?) in a person's life;while gonioscopy can be billed ______ in a year
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once , once
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should you bill for a surgical code along with an exam code?
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no. bill for procedure today. rtc in 2 wks for exam, and then bill for exam.
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how long is the global period for procedures: can not bill for any additional visits
within that period |
10 days
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if, during a global period, you do another procedure that is totally unrelated to the first one (on the same patient) can you bill for it?
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Need for unrelated visit/exam: must use modifier
code to indicate that |
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what codes are surgical codes/
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6-----
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for vision insurance, use these codes
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92
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if your 19 yo patient had a refraction of +.25-.25 x 180 and the patients vision plan does not cover refraction,do you still charge the patient for a refraction?
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No, When billing separate for refraction: only
bill for a prescribable Rx |
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what are "consultation codes"
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Office - a doctor seeking opinion of another doctor, not a referral AND Confirmation: a
patient seeking a 2nd opinion (Must be initiated by patient) |
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Is Systemic hypertension w/o retinopathy a medical diagnosis?
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NOT a medical diagnosis
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can Systemic diabetes w/o retinopathy be billed as a medical diagnosis?
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Yes, it can be billed as a medical diagnosis every year
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V58.69 is a CPT code for when...
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patient is taking a medication that
has ocular side-effects |
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V72.0 is a CPT code for
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emmetropia
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