Optometric Billing-Billing Medicare for 92250-Denials Reported

We have seen Medicare denying 92250 in some regions due to not having a referring provider present on the claim form. Putting the attending physician name and NPI in box 17a and 17b on the claim form (old and new) should fix the problem.

Click here to contact opticXpress to become your billing service. Stop worrying about these denials on your own!

OPTOMETRIC BILLING-BILLING 92133/92134 AND 92250 ON THE SAME DAY

"-According to Medicare’s NCCI Mutually Exclusive Edits, Scanning Laser-Posterior (92133 and 92134) and Fundus Photography (92250) are considered mutually exclusive.
In order to bill them together on the same date of service, the NCCI Mutually Exclusive Edits do allow for the lesser component (92250) to have a different diagnosis and be modified with -59.
The patient could also return another day for the second procedure.
- According to Medicare’s NCCI Correct Coding Edits, Fundus Photography (92250) and Remote Imaging-Detection of Retinal Disease Under Physician Supervision (92227) are considered mutually exclusive and it does NOT allow for any modification to either procedure code." (taken from EyeCor by NTeon)

Want more info like this? Consider a subscription to EyeCOR...we love it! 

You can also use opticXpress as your billing department and you will enjoy the same benefits of EyeCor! Call us today!