Coding success: keep good records, code correctly

PHILADELPHIA – Providing excellent health care is at the heart of the coding process, Charles B. Brownlow, OD, FAAO, said here at the PRIMARY CARE OPTOMETRY NEWS Symposium. “The bill that was passed in 1997 that introduced these codes was liberating, but it hasn’t been well accepted by medical world,” he said. “Unfortunately, there are many ODs who haven’t even read the codes.”

Dr. Brownlow, a PCON Editorial Board member and coding columnist, recommends basing patient care on the following principles: find out the patient’s needs, keep good records and choose codes correctly. In particular, he stresses accurate recording of the reason for visit.

“Even though insurers are predominantly interested in the diagnosis, you must have a reason for the visit to be reimbursed by Medicare standards,” Dr. Brownlow explained. “Even if a patient presents with blurred vision and nothing is diagnosed, it is still legitimate by Medicare standards as long as the correct reason for visit code is used.”

The 99000 codes are based upon patient medical history, physical exam and medical decision-making, he said. Specifically, the physical exam now comprises 12 elements that include evaluation of 10 ocular and two psychiatric elements.

Dr. Brownlow recommends developing your own protocols for common conditions such as chronic open-angle glaucoma, keratoconjunctivitis sicca, posterior vitreous detachment, keratoconus and diabetic checks. “Never compromise your quality of care to accommodate a carrier,” he said.

Codes for Optometry is revised annually and can be purchased through the American Optometric Association by calling (800) 365-2219 or by visiting their Web site: www.aoa.org.