Ophthalmology Medical Billing Services

Outsourcing Ophthalmology Medical Billing Services:

Outsourcing Ophthalmology Medical Billing to an established and proficient Medical Billing Company like e-care add huge value to ensure their end clients needs are met. Medical Billing companies need to clearly understand their clients’ requirement and the medical billing nuances to meet their bottom line. Medical Billing experts study their clients set up and process, tracking them to improvise for betterment and provide them with the best experience.

Medical Coding in Ophthalmology:

Using Modifiers is very important to avoid denials & receive payment on time. Listed below are few codes and modifiers in Ophthalmology:

• Submitting claims with LT (Left Eye) or RT (Right Eye) to avoid denial
• Modifier 78/79 to be appended to specify whether the surgery is Related or Unrelated to the previous Surgery during post-operative period.
• Need to use 50-Bilateral if the procedure performed on both eyes. Few insurance will not process modifier “50: and need to use two lines with LT and other one with RT.
• Eye Lid Modifiers: If provider performs Punctal plugs we need to use appropriate modifier of the lid.
• E1 – Left Upper Eyelid. E2 – Left Lower Eyelid. E3 – Right Upper Eyelid. E4 – Right Lower Eyelid.
• Procedures with Technical and Professional component: Based on the carrier & state, need to file as two line items with 26 & TC.
• Aesthetic Procedures, Frames & Lens: Very few insurances cover these procedures so providers collects payments from the patients upfront for Contact Lens, Frames and Aesthetics Procedures (Astigmatism/Presbyopia correcting function of intraocular lens).