Optometry CPT Codes

CPT Eye Code Checklist

Optometry CPT codes are an important part of the Optometry billing process. They describe what type of Optometrist care has been provided. There are Optometry CPT codes for almost everything a licensed Optometist doctor medical provider can do and more are created each year.

Optometry specialist are commonly responsible for maintaining patient charts, obtaining patients' histories, patient screening, selecting frames for prescription mounting and prescription verification so they need correct CPT codes.

Optometrists are trained to examine the internal and external structure of the eyes to detect diseases like glaucoma, retinal diseases, and cataracts. Optometrists do not perform surgery and are not trained to care for and manage all diseases and disorders of the eyes. Optometrists are trained to diagnose and treat vision conditions like nearsightedness, farsightedness, astigmatism, and presbyopia. They may also test a person's ability to focus and coordinate the eyes and see depth and colors accurately.

Procedure Codes List

Common Mistakes in Optometry CPT Billing

The first common mistake made in cpt coding and billing is submitting a medical exam to a routine insurance carrier. This mistake will result in a much lower reimbursement and overtime can become a financial burden for your practice.
The second common mistake in cpt coding is using modifiers incorrectly. Modifiers are used to describe services more accurately, but when used incorrectly can result in a denied claim.
The third most common error in cpt billing and coding is submitting claims to insurance panels before being properly credentialed. This error will also result in a denied claim.

Using the Right Optometry CPT Code Modifiers

CPT code modifiers help to describe a service accurately since they're often complex.

It will help you in achieving the following: CPT coding

Defining whether the procedure is necessary.
Knowing how many doctors attend to the patient.
If there were many procedures in the past.
The location of the procedures and much other information important to a claim's stand with the insurance financier.

However, if it's applied in a wrong way, it could lead to a high percentage of denied medical claims. The most used modifier for ocular examination comprises of RT/LT for the left and right eye/lid. Also, the E1-E4 modifiers help in differentiating the left and right, as well as the superior and inferior lids.

The CPT modifiers are either alphanumeric or numeric. Thus, they are usually added to the back of a CPT code together with a hyphen. It's wise to understand the various uses of each of the CPT code modifiers before applying them.

Common Optometric Billing and Coding Errors

There are three common billing and coding errors every optometrist should know and avoid. These common errors are:

Over-Coding

Over-coding an examination occurs when you bill a level of service higher than the normal value. An example is when an E/M level 4 replaces the medical record that supports an E/M level 3.

Under-Coding

It's the most common error in optometry. It involves billing a problem-focused evaluation and management office; at a lower level than the examination, decision-making support, and the patient's history.

Billable Procedures

This error is like the under-coding error, but it takes the under-coding a little step further. It happens when you don't finish the coding process by billing the patient's medical insurance for the examination.