coding for macular degeneration 1. office visit as above, 92 or 99 frequency -as medically indicated...

Coding for Macular Coding for Macular Degeneration Degeneration

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Office visit as above, 92 or 99Office visit as above, 92 or 99

FrequencyFrequency-As medically indicated -As medically indicated (q 1mo, 3 mo, 6mo, (q 1mo, 3 mo, 6mo,

12mo)12mo)

-No limit on office visits-No limit on office visits

- AOA recommends q 4 - 6 months, - AOA recommends q 4 - 6 months, depending on risk & severitydepending on risk & severity

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Level of Office VisitLevel of Office Visit- Severe AMD may support higher levelSevere AMD may support higher level

- AMD complicated with other disease - AMD complicated with other disease (eg, glaucoma) may support higher (eg, glaucoma) may support higher levellevel

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Special TestsSpecial TestsScanning Imaging (GDx, OCT)Scanning Imaging (GDx, OCT)

Visual FieldsVisual Fields

Fundus PhotoFundus Photo

Extended OphthalmoscopyExtended Ophthalmoscopy

Genetic TestGenetic Test

Misc TestsMisc Tests

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92134 92134 Scanning computerized Scanning computerized ophthalmic diagnostic imaging, ophthalmic diagnostic imaging, posterior segment, posterior segment,

retinaretina

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Scanning ImagingScanning Imaging

BluePeak™ Blue Laser Autofluorescence BluePeak™ Blue Laser Autofluorescence Imaging, FAFImaging, FAF

No dedicated CPTNo dedicated CPT

Am. Acad. of Ophth. recommends 92499 Am. Acad. of Ophth. recommends 92499 Unlisted serviceUnlisted service

Average Medicare 92499 payment = $111 Average Medicare 92499 payment = $111 in 2008in 2008

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92499 - Submit documentation, describe 92499 - Submit documentation, describe nature, extent, medical necessity, time, nature, extent, medical necessity, time, effort, equipmenteffort, equipment

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Some use 92250 (Some use 92250 (↑ $$)↑ $$)

LCD may not allow scanning laser or be LCD may not allow scanning laser or be silentsilent

file://localhost/Users/alanhomestead/Documents/My Documents B 3-file://localhost/Users/alanhomestead/Documents/My Documents B 3-8-13/Adventures 11-3-12/O - S/Presentations/A-O/Loose Pages/14 8-13/Adventures 11-3-12/O - S/Presentations/A-O/Loose Pages/14 Bill Photo w Scan Laser.docxBill Photo w Scan Laser.docx

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Visual FieldsVisual FieldsAOA suggests central 10 Deg annuallyAOA suggests central 10 Deg annually

99


Visual FieldsVisual FieldsForesee Preferential Hyperacuity Foresee Preferential Hyperacuity

PerimeterPerimeter aka, Foresee PHP™ Visual field analyzeraka, Foresee PHP™ Visual field analyzer

Tests one stimulus brightness level, Tests one stimulus brightness level, matches 92081matches 92081

Vendor recommends every 3-4 months for Vendor recommends every 3-4 months for at riskat risk

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Visual FieldsVisual FieldsForesee Preferential Hyperacuity Foresee Preferential Hyperacuity

Perimeter Perimeter

LCD may say:LCD may say:

-visual field examinations performed at -visual field examinations performed at unusually frequent intervals may be unusually frequent intervals may be reviewedreviewed

1111


Extended OphthalmoscopyExtended Ophthalmoscopy

Rare size requirementRare size requirement

No color requirementNo color requirement

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Genetic TestGenetic TestMacula Risk (ArcticDX, Toronto, Ontario)Macula Risk (ArcticDX, Toronto, Ontario)

1st genetic test for AMD1st genetic test for AMD

866-964-5182866-964-5182

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Genetic TestGenetic TestObtain test kits from ArticDX Obtain test kits from ArticDX (no cost)(no cost)

Take oral swab from patient Take oral swab from patient (office visit) (office visit)

Results forwarded to doc Results forwarded to doc (no fee to doc)(no fee to doc)

Discuss results with patient Discuss results with patient (office visit)(office visit)

Lab bills insurance directlyLab bills insurance directly

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Macular pigment optical density Macular pigment optical density MPODMPOD

-no CPT-no CPT

-can bill 92499 Unlisted service-can bill 92499 Unlisted service

-collect from patient-collect from patient

-Vendors: Macuscope by Marco, MPOD -Vendors: Macuscope by Marco, MPOD by Tinsleyby Tinsley

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Color Vision 92283 Color Vision 92283 –AOA mentions ?–AOA mentions ?

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DiabetesDiabetes

file://localhost/Users/file://localhost/Users/alanhomestead/Documents/My alanhomestead/Documents/My Documents B 3-8-13/Adventures Documents B 3-8-13/Adventures 11-3-12/O - 11-3-12/O - S/Presentations/Repository of My S/Presentations/Repository of My PowerPoints/1 Topic PowerPoints/1 Topic Modules/Diabetes/Diab Aug 13.pptModules/Diabetes/Diab Aug 13.ppt

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