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Conference Roundup
Medicare/Payer/Legislation

Untangling Retinal Coding Issues

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Two experts addressed important retinal coding considerations during the American Society of Cataract and Refractive Surgery’s 2018 annual meeting in Washington, DC. David M. Brown, MD, a partner in Retina Consultants of Houston and Kirk A. Mack, COMT, COE, CPC, CPMA senior consultant with the Corcoran Consulting Group in San Bernardino, CA, made these points: 

  • Membrane peels: Check for both what was done and why.  
  • Review complex retinal detachment criteria. 
  • Understand how lens fragments were removed.  
  • Watch the IOL details for removal, exchange, and reposition (suture is incidental).
  • Modifier 25 is used for some office visits with injections.
  • Do not code extended ophthalmoscopy at every visit. 

Brown D, Mack K. Untangling retinal controversies. Talk presented at: 2018 ASCRS-ASOA Annual Meeting; April 13-17, 2018; Washington, DC.

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