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Posted By Amanda on 05-28-2015, 15:19:00 in Ophthalmology
Can someone share with me where in writing it states that Level 4 and 5s require dilation? Someone told us at a seminar it's in an old publication.

Amanda Kunze, CPC, OCS
Reimbursement Specialist
Eye & Ear Clinic

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Comments (6)
Posted By Laurie Franz on 07-18-2016, 15:05:33
Was it determined that the dilation requirement is for 99xxx not 92xxx office visits?
Posted By Amanda on 05-28-2015, 18:53:00
Actually thanks I think I have it figured it out. Amanda
Posted By Suzanne on 05-28-2015, 18:41:00
See pages 23 and 24 of the E/M Guidelines. =
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/referenceII.pdf

Sue Corcoran
Posted By Amanda on 05-28-2015, 18:23:00
I have my book out and all it says is that a detailed exam only requires 9 bullets, it doesn’t say which ones?? Amanda
Posted By Amanda on 05-28-2015, 18:20:00
Are you saying 92004/92014? I thought I was told for 99204/99205 and 99214/99215 something was published. Amanda
Posted By Suzanne on 05-28-2015, 17:47:00
Amanda,

It is part of the 1997 Evaluation & Management Guidelines published by CMS for single-system coding for ophthalmology. Dilation (unless medically contraindicated) is required for a comprehensive exam.

Sue Corcoran
Corcoran Consulting Group
(800) 399-6565
scorcoran=40corcoranccg.com
www.corcoranccg.com
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