|
Stop throwing away $20 every time you do two VFs for a carrier that only pays for one To prove that blepharoplasty is medically necessary, you have to perform two sets of visual fields per patient - but many Medicare carriers will only pay for one set. You may not ever see full reimbursement for your work, but here's how you can code to get most of what you're due. To prove medical necessity for blepharoplasty, you must show that the drooping eyelids are interfering with the patient's field of vision - accomplished by performing visual field tests (92081-92083). Optometrists must perform a visual field test with the patient's eyelids taped out of the way (in addition to a standard VF), showing what the postoperative field of vision will be, says Beth Welsch, billing manager for Sigma Eyehealth Centers in Monticello, Iowa. Most Medicare carriers require that the untaped VF show an absolute superior defect to within 15 degrees of fixation. The taped VF must demonstrate a significant improvement over the untaped VF, sometimes as much as a 30 percent improvement. Choose Between These Coding Options So how can you get more fair reimbursement when you perform two visual field tests? Scenario: A patient is referred to a plastic surgeon to have part of a droopy eyelid removed because of a decreased field of vision. In order to determine that the droopy eyelid was indeed the cause of the decreased vision, the plastic surgeon asks the optometrist to perform taped and untaped visual field tests. The optometrist submits a bill to Medicare for two units of 92082 (Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination), but the carrier only pays for one procedure. Best way: Code one unit of 92083 (... extended examination) at your regular fee for that code, says Nina Watson, CPC, CMA, an optometry coding consultant in Fayetteville, N.C. Standard coding practices tell you instead of [reporting the two services separately]" just go to the next level of service to cover what it is you're providing for the patient " she says. "The CPT overall rules say that they had rather you submit one package for the service bundling everything into one package versus unbundling and trying to divide it up into individual pieces. Our Medicare carrier here has said that they prefer that we do it that way." Even though the reimbursement for 92083 is about $20 greater than for 92082 "you still aren't getting paid the full amount for what you're doing " Watson says because the overall charge for two units of 92082 would be more than you would get for 92083. Even if you perform visual fields on both eyes just ……….. For more read:-
http://www.supercoder.com/articles/articles-alerts/opt/conquer-the-pre-blepharoplasty-visual-field-coding-conundrum/
Related Articles -
optometry codes, pre-blepharoplasty visual field, pre-blepharoplasty visual field coding, medical coding, medical billing, icd-9 codes, cpt codes, hcp,
| 
