Ophthalmology Billing

Ophthalmology medical billing, like other medical billing, is essential to ensure that an eye care facility remains profitable and viable to continue caring for patients. Because eye care is unique and unlike other specialties, it requires a strong foundation of knowledge to understand the intricate nature of ophthalmology medical billing services. Always check the diagnosis codes, Use E&M codes only when a visit includes a “medical element”, Check for frequency limitations, Documentation requirements vary by payor, Out-of-network (OON) billing. The key to avoiding issues with an OON plan consist of upfront patient collection, transparency with patients regarding cost, and using the same charge amount on claims that you would apply to determine a patient payment. CPT Codes from 92002-92014 are the general ophthalmological services. When reporting E&M codes, these codes should not be reported separately. The E&M services include general ophthalmological services. Special ophthalmologic services represent specific services not included in a general or routine ophthalmological examination. Special ophthalmological services may be reported separately as they are recognized as significant, separately identifiable services. For procedures requiring the intravenous injection of dye or other diagnostic agents, insertion of an intravenous catheter and dye injection is integral to the procedure. These procedures are not separately reportable. The following are not separately reportable CPT codes: 36000 (Introduction of a needle or catheter) 36410 (Venipuncture) 96360-96368 (IV infusion) 96374-96376 (IV push injection) The ophthalmology CPT medical billing code set is maintained by the American Medical Association (AMA). New techniques and technologies are being introduced in healthcare to increase life expectancy. This is why proper and correct medical billing is required to improve the revenue cycle of any ophthalmology practice