Ophthalmology Medical Billing For Digital Eye Strain

by | Published on Dec 31, 2021 | Medical Coding

Ophthalmology Medical Billing
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Digital eye strain or computer vision syndrome is caused due to the prolonged use of computers, mobile phones and such digital devices. This is a worrying health condition and if it is left untreated, the symptoms will exacerbate. The symptoms can be broadly classified into two categories:

  1. Binocular Vision Dysfunction
  2. External symptoms associated with dry eye

Primary importance is to be given for coding accuracy on the medical claims healthcare providers submit to insurers. Ophthalmology medical billing service providers can help providers ensure hassle-free revenue cycle management. Reducing the number of claim denials and timely reimbursement are given utmost priority by a medical billing and coding company. This is the reason why medical practices, ophthalmologists and physicians utilize reliable billing and medical coding services.

Outsource Strategies International has a dedicated team of well-informed, trained professionals who are adept at assigning appropriate codes, billing and following up on reimbursement claims sought from insurance companies by the health care providers. The staffs are well-versed in accurately entering the required CPT and ICD-10 codes. The patient details and dates of service should be error-free. A close scrutiny of the data at multiple levels is inevitable.

Ophthalmic diseases associated with Digital Eye Strain are Strabismus, visual disturbance, and blindness to cite a few. Assigning the corresponding codes and modifiers is a great challenge but medical coding services make the task easier.

Diagnosis

Diagnosing the underlying cause of poor vision is a very important step in managing the condition. Digital eye strain is caused as a result of the combination of many factors.

A complete eye examination of the patient with specific focus on medical history is carried out by the ophthalmologists to have an accurate diagnosis. Post medical examination, the patient may be directed to undergo dilation of the pupils. Some patients may require follow-up tests and blood tests to have a better analysis of the health conditions.

A medical billing and coding company can help medical practitioners focus on the effective treatment strategies for their patients without getting worried about sprucing up the claims for reimbursement. The proficient billers and coders ensure that the client is adequately compensated by accurately preparing the claim and including all the appropriate medical codes.

Relevant ICD-10 Codes for Digital Eye Strain

The ICD-10 code assigned to Diseases of the Eye and Adnexa is H00-H59.

  1. H49-H52: Disorders of ocular muscles, binocular movement, accommodation and refraction.
    • H49: Paralytic strabismus
    • H50: Other Strabismus
    • H51: Other disorders of binocular movement.
    • H52: Disorders of refraction and accommodation.
  2. H53-H54: Visual disturbances and blindness.
    • H53: Visual disturbances
    • H54: Blindness and low vision

CPT Codes Associated with Digital Eye Strain

The CPT code range for Ophthalmologic Services and Procedures is 92002 to 92499. The relevant codes to report Digital Eye Strain are:

  1. 92002-92014 : General Ophthalmological Services and Procedures
    • 92002-92004: New Patient General Ophthalmological Services and Procedures.
    • 92012-92014: Established Patient General Ophthalmological Services and Procedures.
  2. 92015-92287: Special Ophthalmological Services and Procedures.
    • 92015-92145: Ophthalmological Examination and Evaluation Procedures.
    • 92201-92260: Ophthalmoscopy Procedures
    • 92265-92287: Other Specialized Ophthalmological Services and Procedures.
  3. 92340-92371: Spectacle Services
    • 92341: Describes the eyeglasses of bi-focal type.
    • 92342: Fits eyeglasses that are multi-focal rather than bi-focal.
    • 92354: The provider fits magnifying lens on the eyeglasses to improve a patient’s near vision for tasks like reading.
    • 92355: The provider fits a telescopic lens on the eyeglasses for tasks that require better near vision.
  4. 92499-92499: Other Ophthalmological Services or Procedures.
    • 92499: Used to report Ophthalmological Procedures that do not have a specific code.

Choosing the Right Code – Whether E/M Code or Eye Code

Ophthalmologists are required to aptly choose between E/M Code and Eye Code. The primary goal of a billing and coding company is to aid providers in accurately specifying the correct code.

It depends on the following factors:

  • Presence of a medical element during patient visit.If the patient visit is purely for visual examination it doesn’t possess a medical element and Eye Code should be chosen.
  • The patient historyThe number of patient visits has to be analyzed because there is reimbursement limit for Eye Codes based on the frequency of the visits. E/M Code has no such restriction.
  • Evaluation of diagnosis codesEye Codes are applicable only if the diagnosis requires medical necessity. However, E/M code has no such restriction.
  • Documentation of the payerThe documentation of the payer has to be verified because E/M Codes are standardized for all payers. But there can be variations in documentation required for Eye Code.
  • Remunerative attributesChoose code that gives high reimbursement.

Why Should a Medical Practitioner Utilize Medical Coding Services?

Medical Billing and Coding Companies are adept at handling the entire billing spectrum from assigning appropriate codes to following up with the insurance companies for timely reimbursement of the claims. By outsourcing, the health care providers can focus on the better care of their patients and concentrate on strategic advantages required for their business.

Other benefits include:

  • Error-free documentation of the patient details.
  • The ICD-10 codes are frequently revised and keeping up with the changes will not be a daunting task, if a medical billing and coding company is hired.
  • Helps to cut back on claim denials.
  • Increased revenue as there is no need of additional staffs and coding specialists.
  • Aids in financial optimization by avoiding the operational costs.
  • Makes the client company compliant with the regulations put forth by the government.
  • Eliminates over coding and under coding as it can earn the wrath of auditors.
  • Efficient management of reimbursement of the claims by working round the clock.
  • Tirelessly work to expedite the claim of critical applications.
  • The services extended will be aligned with the client’s business requirements.

How Crucial Is Ophthalmology Medical Billing Service?

Nowadays, the number of patients dealing with Digital Eye Strain is increasing. Prevention of this condition is the only solution but the role of digital devices in this era is inevitable. So, we promise health care providers the ample time they require to provide better care for their patients.

Also, eye care providers are struggling to maintain a balance between limiting overhead expenses and providing the best treatment for their patients. We are duty-bound to ensure the smooth functioning of the client’s health care organization.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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