Optometry Medical Billing Services

Optometry Medical Billing Services

Every Optometrist practice or Doctors of Optometry face challenges in coding and billing. Professional coding and billing expertise is necessary to code and bill primary eye care claims. Optometry coding and billing is complex and requires experienced, trained and certified coders to accurately code the procedures such as routine eye exam,refractions, ophthalmic diagnostic imaging, optic nerve, fundus photography, contact lenses, perimetry testing, OCB (Optical coherence biometry), fluorescein angiography, refractive vision exams, binocular and accommodative tests, retinoscopy, ametropia, binocular and biocular balance refraction in VL, stereopsis, convergence, phoria, opthalmoscopy, pupillary functions, ocular tonometry, biomicroscopy etc. Medisys Data Solutions brings years of optometry coding and billing experience to your practice. Your optometry practice needs the skills and experience to handle complex optometry procedures. We at Medisys Data Solutions are recognized in optometry coding and billing.

Below are a few steps from optometry billing professionals

  • Incorrect use of modifier 59 and 25: Optometrists should make sure that modifier 25 is used appropriately to report a significant separately identifiable E/M service by the same physician on the day of a procedure. Also, modifier 59 is to be used appropriately to report “Distinct Procedural Service” – Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day.
  • Coding and billing updates: Keeping abreast with the coding updates by maintaining ICD 10 CM, PCS, HCPCS, CPT code books is imperative. CMS website publishes frequent updates to the coding rules and guidelines. The AAO (American Academy of Optometry) and AOA (American Optometric Association) publishes frequent newsletters and journals. Frequent reference to CMS websites and subscriptions to articles will keep the providers updated on optometry coding and billing.
  • Quality checks and audits: Regular quality checks and frequent audits of coding is a must to avoid repetition of errors. There needs to be open communication between physicians, coders, billers. Optometrists need to be educated by coders and billers frequently used ICD and CPT codes by the practice and denials/rejections.
  • Upcoding: Coders and billers entries in the practice management software should match with the actual diagnosis and procedure codes done by the optometrist. The coders have to be careful while coding expensive procedures which are unnecessarily billed than what was actually performed by the optometrist.

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