Ophthalmology Coding: Report Emergency Services Separately?

By Author: Angela Martin
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Should you report emergency services separately? Well, the answer may depend on your carrier.

Tending to ophthalmic emergencies in the office is tough; as such your office should get more reimbursement is it? But that's not always the way Medicare sees it. Read on for some expert advice that will help you get fair reimbursement for the ophthalmologist's extra work.

When a patient rushes in with a corneal laceration from glass stuck in his eye, you know that the ophthalmologist requires more time and skill than usual to deal with the traumatic eye injury. Even then Medicare has strict ophthalmology coding billing rules for emergencies in the office.

Some of the most common traumatic eye injuries ophthalmologists might tend to in the office are foreign body (FB) removals (65205-65222) and laceration repairs (65270-65286). The code report depends on the location of the foreign body and the resulting, if there are any.

For instance, use 65205 for a conjunctival FB and 65220 ...
... for a corneal FB.

If the ophthalmologist removes FBs from different anatomical parts of the same eye, however, then you can use a pair of codes.

Example: The ophthalmologist removes a superficial conjunctival FB and a corneal FB from a patient's right eye; there's evidence of slit lamp use in the notes. You would report the following:

65222 for the slit lamp removal with 930.0 appended to represent the FB

65205 for the conjunctival removal with 930.1 appended to represent the FB.

For more ophthalmology coding billing tips and ways to treat ophthalmic emergencies in the office, sign up for an audio conference. On registering yourself for such a conference, you'll stay up to date on all ophthalmology coding know how. And even if you miss out on a scheduled conference, you can always fall back on CDs and PDF transcripts of the same. You even stand to acquire CEUs on attending one.