There have been some important coding changes for 2020.

EXTENDED OPHTHALMOSCOPY

First of all, CPT codes 92225 and 92226 for extended ophthalmoscopy were deleted as of January 1, 2020. We now have two new codes based upon what area of the retina was examined and documented. (Ophthalmoscopy is no longer reported as initial and subsequent testing.) Use 92201 for examination of the retinal periphery or 92202 for the optic nerve and macula. Another important change for extended ophthalmoscopy is billing. These codes are now considered bilateral and are billed on one line with one reimbursement. (The old codes were billed per eye.) This, of course, is going to impact our doctors’ reimbursements.

NEW CATARACT SURGERY CODES

Additionally, starting January 1, 2020, two new codes were added for cataract surgeries: 66987 and 66988. These codes are used when two surgeries are done together to treat both cataracts and glaucoma. The surgeon first performs traditional cataract surgery with IOL insertion and then performs a laser surgery called ECP (Endoscopic Cyclophotocoagulation) for patients with uncontrolled glaucoma to reduce their intraocular pressures. CPT 66987 is for complex cataract surgery with ECP, and CPT 66988 is for basic cataract surgery with ECP. Also, the description for existing cataract surgery codes 66982 and 66984 have now been revised to read “without endoscopic cyclophotocoagulation.” We may start to see some of these new cataract surgery codes as we bill co-manages in the coming months.

6/18/19  EyeMed appears to be dropping remits this week from 6/4/19 that have not previously shown up on their website. Therefore, billers need to check their disbursement history to see if they have EOBs that weren’t there two weeks ago. Also, we’re also finding that some of these back-dated remits have no lab charges listed, so the checks don’t balance. However, if you look up the remit on EyeMed’s website, the claim is listed correctly so you can post and balance. Oh, the joys of billing!