Coding for Macular Degeneration

1
Coding for Macular Degeneration
2
Coding for Macular Degeneration

• Office visit as above, 92 or 99
• Frequency
• -As medically indicated (q 1mo, 3 mo, 6mo, 12mo)
• -No limit on office visits
• - AOA recommends q 4 - 6 months, depending on
  risk severity

3
Coding for Macular Degeneration

• Level of Office Visit
• Severe AMD may support higher level
• - AMD complicated with other disease (eg,
  glaucoma) may support higher level

4
Coding for Macular Degeneration

• Special Tests
• Scanning Imaging (GDx, OCT)
• Visual Fields
• Fundus Photo
• Extended Ophthalmoscopy
• Genetic Test
• Misc Tests

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Coding for Macular Degeneration

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

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Scanning Imaging

• BluePeak Blue Laser Autofluorescence Imaging,
  FAF
• No dedicated CPT
• Am. Acad. of Ophth. recommends 92499 Unlisted
  service
• Average Medicare 92499 payment 111 in 2008

7
Scanning Imaging

• BluePeak Blue Laser Autofluorescence Imaging,
  FAF
• 92499 - Submit documentation, describe nature,
  extent, medical necessity, time, effort,
  equipment

8
Scanning Imaging

• BluePeak Blue Laser Autofluorescence Imaging,
  FAF
• Some use 92250 (? )
• LCD may not allow scanning laser or be silent
• file//localhost/Users/alanhomestead/Documents/My
  Documents B 3-8-13/Adventures 11-3-12/O -
  S/Presentations/A-O/Loose Pages/14 Bill Photo w
  Scan Laser.docx

9
Coding for Macular Degeneration

• Visual Fields
• AOA suggests central 10 Deg annually

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Coding for Macular Degeneration

• Visual Fields
• Foresee Preferential Hyperacuity Perimeter
• aka, Foresee PHP Visual field analyzer
• Tests one stimulus brightness level, matches
  92081
• Vendor recommends every 3-4 months for at risk

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Coding for Macular Degeneration

• Visual Fields
• Foresee Preferential Hyperacuity Perimeter
• LCD may say
• -visual field examinations performed at unusually
  frequent intervals may be reviewed

12
Coding for Macular Degeneration

• Extended Ophthalmoscopy
• Rare size requirement
• No color requirement

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Coding for Macular Degeneration

• Genetic Test
• Macula Risk (ArcticDX, Toronto, Ontario)
• 1st genetic test for AMD
• 866-964-5182

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Coding for Macular Degeneration

• Genetic Test
• Obtain test kits from ArticDX (no cost)
• Take oral swab from patient (office visit)
• Results forwarded to doc (no fee to doc)
• Discuss results with patient (office visit)
• Lab bills insurance directly

15
Coding for Macular Degeneration

• Macular pigment optical density MPOD
• -no CPT
• -can bill 92499 Unlisted service
• -collect from patient
• -Vendors Macuscope by Marco, MPOD by Tinsley

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Coding for Macular Degeneration

• Color Vision 92283 AOA mentions ?

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Diabetes

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