As I sort through my mail, seeing flyers for Optometrys Meeting in Seattle, it dawns on me that its already June and half of 2008 has cruised by. This column, Coding Abstract, is already six months old, and it has been a true pleasure bringing it to you each month. Our team of contributing authors has been working hard to make sure that the information contained in each article is timely, succinct, germane to the feature topic of that months issue of Review of Optometry, and most importantly, accurate in the coding details provided.

Keep in mind that our goal is to show you how to code properly and mitigate any risk you might face. You work hard to provide the highest standard of care, and we hope that you have found this column to complement your efforts by accurately translating the clinical standard of care into language that your third-party carriers understand and will pay for. Our objective is pure and simple: to teach you how to get properly reimbursed for the high level of care you provide to your patients, while minimizing your risk by doing things correctly the first time. Lets look at the topics weve covered to date:

February: Dry eye. D.C. Dean, O.D., thoroughly outlined the various approaches to dry eye coding. He emphasized the importance of the appropriate relationship between the diagnosis and the procedures so as not to violate ICD-9 policy (in the absence of a diagnosis, you can only use the patient symptom as a diagnosis), and the risk associated with misusing modifier -25 for office visits that occur on the same day as minor surgical procedures.

March: Cataract comanagement. David Mills, O.D., M.B.A., did a fabulous job of outlining the mechanics of the comanagement relationship and the guidelines in establishing an appropriate working relationship with your cataract surgeon to insure that you are properly reimbursed for the post-operative portion of care without violating federal guidelines.

April: Keratoconus. Laurie Sorrenson, O.D., clarified the very frustrating challenge of coding for the management of keratoconus, highlighting the misuse of CPT code 92070, and articulating the mechanics of the contact lens fit, the V-codes for materials, the 9921X and 9201X codes for follow-up care, and the use of modifier -22 appended to the contact lens fitting (9231X).

May: Medical necessity. Last month, I defined medical necessity and its importance in the medical record, and therefore its role in billing for our services appropriately to help avoid common audit triggers and ensure proper care for the patient.

Each of these topics has been well received, and the comments from you have been excellentso keep them coming.
In upcoming issues, the topics on our calendar are just as engaging as those covered in the first six months. Heres whats in store for the remainder of the year:

In July, Rebecca Wartman, O.D., will discuss the appropriate use of the CPT codes typically associated with caring for the glaucoma patient.

In August, Dr. Dean will address how to incorporate new technology and properly code its use in our practices.

In September, Dr. Mills will cover the popular topic of coding for the patient with diabetes and the appropriate application of coordinating the patients refractive and medical benefits.

In November, Dr. Sorrenson will delineate coding for the diagnosis and treatment of common anterior segment disorders.

In October and December, Ill be incorporating updates on the ICD-10 implementation and the 2009 OIG work plan.

Keep in mind that this column is about doing things rightthe first time. Your comments and suggestions for new topics are appreciated and always welcome. We encourage you to send your comments, criticisms and topic suggestions to:

Clinical Coding Committee

John Rumpakis, O.D., M.B.A., Clinical Coding Editor

D.C. Dean, O.D.

David Mills, O.D., M.B.A.

Laurie Sorrenson, O.D.

Rebecca Wartman, O.D.

Vol. No: 145:06Issue: 6/15/2008