subject: Ophthalmology coding: Know the key modifiers for your AMD claims [print this page] Ophthalmology coding: Know the key modifiers for your AMD claims
Ophthalmology is the field of medicine which deals with the diagnosis and treatment of disorders of the eye. As such, ophthalmology coding is the method of coding the diagnostic procedures for treatments pertaining to ophthalmology.
An important component of ophthalmology codes is the right use of modifiers. The wrong modifier can wreck havoc on your claims.
As with other ophthalmology services, the wrong modifier can pour waters on your Age-related Macular Degeneration (AMD) claims. You need to finish your claim with modifiers LT (Left side) or RT (Right side) as correct. You may also have to append modifier 24 or modifer 25.
A patient under goes cataract surgery, and sees your retina specialist during the post-op period for follow-up of wet macular degeneration. Since the wet AMD is not related to cataract surgery, you need to append modifier 24 here.
Modifier 25 is commonly used when the patient comes in for an examination and during the test, the doctor decides on an intravitreal injection. Here you need to append modifier 25 to the E/M or eye code to show that the exam and injection were separately identifiable services. The modifier would not have been used if the decision to perform the intravitreal injection had been made at an exam performed prior to that day.
To get more insight on ophthalmology coding and ways to get your modifiers right, go for an audio conference and see the difference it brings to your ophthalmology coding know-how.
When you register yourself for an ophthalmology coding audio conference, you'll certainly get on top of your Ophthalmology coding. So get going.
