As an optometrist, one of the most important procedures you give your clients is a Visual Field (92081,92082,92083) but it is also one of the most commonly misbilled procedures in the optometric billing field. The biggest reason for this is that it is commonly not paired with a correct diagnosis code which means you loose money because it is denied as "medically unnecessary". You can avoid this by first determining whether or not it is deemed medically necessary to perform a visual field by check the attached chart to see if the diagnosis you are suspecting qualifies for a visual field. If it does not then you need to explain to the patient that you feel it is necessary to perform the procedure and CHARGE THE PATIENT! You would then bill the insurance company with a "-GY" modifier. MAKE SURE THAT YOU INCLUDE THIS INFORMATION IN THE PATIENT'S ADVANCE BENEFICIARY NOTICE (ABN) !
opticXpress is an optometric billing company that provides a clearinghouse, billing service and software strictly for optometrists.
Friday, March 23, 2012
Optometric Billing-How To Properly Bill For Visual Fields
Using Medicare's Local Coverage Determinations (LCD's) as a guide to billing ALL insurance companies is a good strategy to employ. Though it does not guarantee payment across the board, it is, in my opinion, a key way to increase reimbursements. This is because Medicare is, by far, the most stringent payer in terms of rules for coverage.
As an optometrist, one of the most important procedures you give your clients is a Visual Field (92081,92082,92083) but it is also one of the most commonly misbilled procedures in the optometric billing field. The biggest reason for this is that it is commonly not paired with a correct diagnosis code which means you loose money because it is denied as "medically unnecessary". You can avoid this by first determining whether or not it is deemed medically necessary to perform a visual field by check the attached chart to see if the diagnosis you are suspecting qualifies for a visual field. If it does not then you need to explain to the patient that you feel it is necessary to perform the procedure and CHARGE THE PATIENT! You would then bill the insurance company with a "-GY" modifier. MAKE SURE THAT YOU INCLUDE THIS INFORMATION IN THE PATIENT'S ADVANCE BENEFICIARY NOTICE (ABN) !
As an optometrist, one of the most important procedures you give your clients is a Visual Field (92081,92082,92083) but it is also one of the most commonly misbilled procedures in the optometric billing field. The biggest reason for this is that it is commonly not paired with a correct diagnosis code which means you loose money because it is denied as "medically unnecessary". You can avoid this by first determining whether or not it is deemed medically necessary to perform a visual field by check the attached chart to see if the diagnosis you are suspecting qualifies for a visual field. If it does not then you need to explain to the patient that you feel it is necessary to perform the procedure and CHARGE THE PATIENT! You would then bill the insurance company with a "-GY" modifier. MAKE SURE THAT YOU INCLUDE THIS INFORMATION IN THE PATIENT'S ADVANCE BENEFICIARY NOTICE (ABN) !
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