There are many things one might wish to have, as part of a comprehensive pre
cataract work up, such as Specular Micrography, OCT and / or topography. Alas,
these all have very narrow criteria and just “cataract” won’t cut it.
Sometimes, if you do these tests routinely just because a) you need them to
feel better about your case before surgery or b) it’s the right thing to do ala
the “Mom” rule AND you find pathology, you can then justify it with the proper
ICD.10 code. But it’s a gamble
D.
Denice Barsness, CRA, COMT, CDOS, FOPS
CPMC Dept of Ophthalmology/ The Eye Institute
Ophthalmic Diagnostic Services
711 Van Ness Avenue Suite 250
San Francisco CA 94109
415-600-5781
FAX 415-558-7011
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On ;
Behalf Of Lori Guerette
Sent: Wednesday, January 02, 2019 9:22 AM
To: optimal@xxxxxxxxxxxxx
Subject: [**External**] [optimal] Re: Billing question
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Let me clarify
I understand that the dx code and the testing need to match. Ie: you can’t
bill an ONH OCT with the dx of cataract.
Thanks
Lori
May you find your marbles,
And recall the carefree joy of childhood
On Jan 2, 2019, at 11:47 AM, Lori Guerette
<justhitanykey@xxxxxxxxx<mailto:justhitanykey@xxxxxxxxx>> wrote:
Recently we have a new person start in our billing office (not a certified
coder, a technician learning the ropes),
and a memo came out that in order to be reimbursed for any testing (OCT,
photos, etc.) we have to use different diagnoses than used for the exam.
ie: exam billed with dx of cataract, and OCT with dx of DME. Can’t bill both
exam and the OCT with same dx of DME. Told they won’t pay the OCT.
Is this true?
Thanks,
Lori
Lori Guerette, CRA COA OCT-C
May you find your marbles,
And recall the carefree joy of childhood
