[optimal] From Denice re Billing and Coding for Ophthalmic Ultrasound
- From: CPMC Ophthalmic Diagnostic Center <cpmceyelab@xxxxxxxxxxxxxxxx>
- To: <optimal@xxxxxxxxxxxxx>
- Date: Thu, 15 Mar 2012 09:50:11 -0700
Here are the various codes for ultrasound. Rhonda is correct. In addition
to the proper CPT code, each CPT code is only "eligible" for certain
diagnosis's, not unlike photography. Will send correct ICD.9 codes in separate
eMail.
Denice
DIAGNOSTIC OPHTHALMIC ULTRASOUND BILLING
Definitions: A mode implies a one-dimensional ultrasonic measurement
M-mode implies a one-dimensional ultrasonic measurement
Procedure with movement of the trace to record
amplitude and velocity of moving echo-producing
structures
B-scan implies a two-dimensional ultrasonic scanning
procedure
With a two-dimensional display
Real-time scan implies a two dimensional ultrasonic
scanning
Procedure with a display of both two-dimensional
structure and
motion with time ( kinetic scanning, i.e. movies )
CPT Codes
76510
Ophthalmic ultrasound, diagnostic, B-scan, and quantitative A-scan performed
during the same patient visit
Clinical name: Diagnostic B-scan AND Standardized A-scan( used typically in a
tumor setting, when you want to view the
lesion with B-scan AND quantify its internal nature by standardized A-scan
76511
Ophthalmic ultrasound, echography, diagnostic: quantitative A-scan only
Clinical name: Standardized A-Scan
76512
Ophthalmic ultrasound, diagnostic; B-scan ( with or without superimposed
non-quantitative A-scan
Clinical name: Diagnostic B-Scan
76513
Immersion ( water bath) diagnostic B-scan
Clinical name: Immersion B-scan
76516
Ophthalmic biometry by ultrasound echography
Clinical name: Axial Eye Length Biometry by echography
92136
Ophthalmic biometry by partial coherence interferometry with IOL
power calculation
Clinical name: Axial Eye Length Biometry by IOL master
Remember, you cannot bill for Echographic Biometry and Optical Biometry on the
same day or for the same patient. You may PERFORM both, and bill for one or
the other.......
When doing both eyes on the same day, physician may bill for the professional
component for each eye at the time of surgery. The technical component is
billable and payable only once.
If biometry has been done elsewhere, or MD feels it needs to be repeated for
medical necessity, you may bill for biometry more than once in a year.
Otherwise, only payable once- considered a lifetime procedure
76519
Ophthalmic Biometry by ultrasound echography with IOL calculation
Clinical name: Axial Eye Length Biometry with IOL calculation. ( This is the
code used unless you are only measuring the eye to know it's length and NOT
implanting an IOL )
76519
Ophthalmic ultrasonic foreign body localization
Clinical name: Diagnostic B-scan.
( this is a specialty code used when looking for an intraocular foreign body.
This code assumes you need to spend extra time with the B-scan looking for a
foreign body in the eye )
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937 FAX (415) 600-6563
-----Original Message-----
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of sandor ferenczy
Sent: Friday, March 09, 2012 2:46 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Billing for UBM
as Rhonda said, make sure they are billing with an appropriate
diagnosis code. the AAO's ophthalmic coding coach book is a big help
with that. we keep a copy in our clinic.
https://secure.aao.org/EbusPPROD/AcademyStore/ProductDetail/tabid/55/ProductId/24617/Default.aspx
sandor
Sandor Ferenczy, CRA, OCTc
Ophthalmic Photographer
Ocular Oncology Service
Wills Eye Institute
840 Walnut Street, 14th Floor
Philadelphia, Pa 19107
www.fighteyecancer.com
On Fri, Mar 9, 2012 at 3:44 PM, Cheek, Scott <scheek@xxxxxxxxxxxx> wrote:
> I am writing on behalf of a customer who claims his local Medicare providers
> will not reimburse him for UBM CPT 76513. He is located in Albany, NY.
> What I would like to know is if there are any others out there billing for
> UBM in this region successfully or if anyone else has experienced this
> denial.
>
>
>
>
>
> Scott Cheek
>
> Ultrasound Division Manager
>
> Accutome, Inc
>
> 3222 Phoenixville Pike
>
> Malvern, Pa 19355
>
> 800-979-2020
>
> 610-889-0200
>
> Fax: 610-889-3233
>
> www.accutome.com
>
>
>
>
Other related posts:
