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(Bill Ins) 24-OV During PO 99204 25 57 Extend RIT START: RIT DONE: ARRIVED: DESK UP: WORK-UP START: WORK-UP DONE: □ DILATE □ TEACH TIME DR EXAM START: CK-OUT: CPT (PROCEDURE) CODES NEW E&M OV-no ov in 3yrs MISCELLANEOUS CONTACT LENS SERVICES (INS) MODIFIERS 99205 25 57 Advanced NC No Charge 92311 Fit, Aphakia one eye (Bill Ins) 24-OV during PO 99204 25 57 Extend PO Post-op 92312 Fit, Aphakia both eyes (Bill Ins) 25-OV/SX same day (0-10 PO) 99203 25 57 Interm 99050 After Hrs | 99051 Wknd/Hol CONTACT LENS APHAKIC PRODUCT 50-Bilateral sx (qty 1, dbl price) 99202 25 57 Brief OFFICE VISITS - PT PAY V2500 $ (lens) Aphakic Soft Daily Wear 51-Multi sx(topline) NEW EYE (" "3yrs) NPC New - Extend V2513 $ (lens) Aphakic Gas Perm EW 57-Ov/sx same day (90 PO) 92004 25 57 Extend NPI New - Interm V2599 $ (lens) Bandage CL 79-Sx not related 92002 25 57 Brief NPB New - Brief ESTABLISHED E&M OV EPC Est - Extend PROCEDURES SUPPLIES, OTHER 99215 25 57 Advanced EPI Est - Interm 67820C RT LT 79 Epilation-per eye *Provider, POS = ABO; Location = Clinic 99214 24 25 57 Extend EPB Est - Brief 68810C RT LT 79 Probing of NLD PATCH (cloth-indiv) PT PAY 99213 24 25 57 Interm EPO Est - OVO 65205C RT LT 79 FB Conj, superficial PATCHB (adh-box) PT PAY 99212 24 25 57 Brief TESTS 65210C RT LT 79 FB Conj, embedded V2718 (Fresnell Pr) PT PAY 99211 24 25 57 OVO 92015 Refraction 65222C RT LT 79 FB Cornea WITH SL Provider, POS, Location = ABO ESTABLISHED EYE OV 92015P " " Pt Pay 65220C RT LT 79 FB Cornea w/OUT SL MEDREC (Medical Records) See List for $ 92014 25 57 Extend 92060 Sensorimotor 92012 25 57 Brief 92060F " " DETROIT 92225 EO-Init RT LT EYES: 1 = RIGHT EYE 2 = LEFT EYE 3 = BOTH EYES | A = INITIAL ENCOUNTER D = SUBSEQUENT S = SEQUELA | LIDS: 1 = RUL 2 = RLL 4 = LUL 5 = LLL CONJUNCTIVA/SCLERA GLAUCOMA LIDS/LACRIMAL/ORBIT MUSCLES/MOVEMENTS/BINOCULAR VA + 1X 2X LIDS: 1 = RUL 2 = RLL 4 = LUL 5 = LLL S05.0 Abrasion + A D S EYES: 1 = RIGHT 2 = LEFT 3 = BOTH H52.53 + 1 2 3 Accomodative spasm H10.53 + 1 2 3 Bleph'conjunctivitis, contact Q15.0 Congenital, Infant/Juvenille H01.02 + 1 2 4 5 Blepharitis, squamous H53.01 + 1 2 3 Amblyopia, deprivation H10.45 Conjunctivitis, allergic H40.01 + 1 2 3 Open angle, borderline H01.01 + 1 2 4 5 Blepharitis, ulcerative H53.02 + 1 2 3 Amblyopia, refractive H10.1 + 1 2 3 " " , atopic H40.05 + 1 2 3 Ocular hypertension G24.5 Blepharospasm H53.03 + 1 2 3 Amblyopia, strabismic B30.1 " " , due to Adenovirus H40.00 + 1 2 3 Suspect, Glaucoma H02.52 + 1 2 4 5 Blepharosphimosis H53.04 + 1 2 3 Amblyopia, suspect H10.01 + 1 2 3 " " , follicular, acute Stage: 1=Mild,2=Mod,3=Severe,4=Indeterm H00.03 + 1 2 4 5 Cellulitis/Absess, lid H50.61 + 1 2 Brown's syndrome H10.43 + 1 2 3 " " , follicular, chronic + 1 2 3 H05.01 + 1 2 3 Cellulitis, orbit H40.11 Primary/Chronic, Open ang H10.41 + 1 2 3 " " , GPC + 1 2 3 4 H00.1 + 1 2 4 5 Chalazion B00.53 " " , Herpesviral + 1X 2X 3X + 1X 2X H51.11 Convergence insufficiency H40.3 Secondary, eye trauma S00.1 Contusion, lid (ecchymosis) H10.02 + 1 2 3 " " , mucopurulent + 1 2 3 4 + A D S H53.2 Diplopia P39.1 " " , neonatal + 1X 2X 3X + 1X 2X Contusion, orbital tissue or H51.8 Divergence insufficiency H40.4 Secondary, inflammation S05.1 H10.42 + 1 2 3 " " , simple chronic + 1 2 3 4 + A D S globe H50.81 + 1 2 Duane's syndrome H10.21 + 1 2 3 " " , toxic + 1X 2X 3X H04.43 + 1 2 3 Dacryocele H51.8 DVD/DHD, other binocular H40.5 Secondary, other eye dz H10.44 " " , vernal (no cornea invol) + 1 2 3 4 H04.32 + 1 2 3 Dacryocystitis, acute H50.51 Esophoria H15.11 + 1 2 3 Episcleritis IRIS/PUPIL/ANT CHAM L20.89 Dermatitis, atopic (other) H50.43 Esotropia, ACCOMODATIVE + 1X 2X Q13.1 Aniridia Q10.1 Ectropion, congenital T15.1 Foreign body + A D S H57.02 Anisocoria H02.12 + 1 2 4 5 Ectropion, mechanical H50.05 Esotropia, ALTERNATING H11.3 + 1 2 3 Hemorrhage Q13.0 Coloboma, iris Q10.2 Entropion, congenital H50.06 " ", A Pattern + 1X 2X Q13.2 Congenital malform, iris H02.02 + 1 2 4 5 Entropion, mechanical H50.07 " ", V Pattern S05.3 Laceration + A D S H21.32 + 1 2 3 Cyst, iris and/or ant chamb H04.21 + 1 2 3 Epiphora, excess lacrimation H50.32 " ", Intermittent D31.0 + 1 2 Neoplasm/Dermoid/Nevus H21.23 + 1 2 3 Heterochromia H04.22 + 1 2 3 Epiphora, insufficient drainage H50.01 + 1 2 Esotropia, MONOCULAR H11.13 + 1 2 3 Pigmentation H21.0 + 1 2 3 Hyphema + 1 2 H50.02 + 1 2 " ", A Pattern S02.3XX Fracture, orbital floor H15.01 + 1 2 3 Scleritis, anterior + 1X 2X + A B D G K S H50.03 + 1 2 " ", V Pattern S05.1 Hyphema, traumatic H15.03 + 1 2 3 Scleritis, posterior + A D S Initial: A = Closed, B = Open | S = SequelaH50.31 + 1 2 " ", Intermittent H20.05 + 1 2 3 Hypopyon Subsequent: D = Healing, G = Delayed healing, K = nonunionH50.52 Exophoria CORNEA H20.01 + 1 2 3 Iritis/Uveitis, primary D18.01 Hemangioma, skin/subcutan H50.15 Exotropia, ALTERNATING + 1X 2X H20.1 + 1 2 3 " ", Chronic D18.09 Hemangioma, other H50.16 " ", A Pattern S05.0 Abrasion + A D S H44.11 + 1 2 3 " ", Panuveitis H00.01 + 1 2 4 5 Hordeolum, externum H50.17 " ", V Pattern H18.82 + 1 2 3 Disorder from CLs H30.2 + 1 2 3 " ", Posterior cyclitis H00.02 + 1 2 4 5 Hordeolum, internum H50.34 " ", Intermittent H16.22 + 1 2 3 Dry Eye Syndrome, Sicca H20.03 + 1 2 3 " ", Secondary, infectious B00.59 HSV, dermatitis only H18.59 Dystrophy, hereditary H20.04 + 1 2 3 " ", Secondary, non-infect S01.11 + 1 2 Laceration, lid H18.23 + 1 2 3 Edema, secondary H44.13 + 1 2 3 " ", Sympathetic + A D S H50.11 + 1 2 Exotropia, MONOCULAR H18.21 + 1 2 3 Edema, secondary to CL H44.53 + 1 2 3 Leukocoria Q11.2 Microphthalmos H50.12 + 1 2 " ", A Pattern + 1X 2X Q07.8 Marcus-Gunn pupil B08.1 Molloscum contagiosum H50.13 + 1 2 " ", V Pattern T15.0 Foreign body + A D S H21.4 + 1 2 3 Membrane, pupillary D23.1 + 1 2 Neoplasm/Dermoid, lid H50.33 + 1 2 " ", Intermittent B00.52 Keratitis-HSV-dendritic H57.04 Mydriasis D31.6 + 1 2 Neoplasm/Dermoid, orbit H50.2 + 1 2 Hypertropia, vertical H16.14 + 1 2 3 Keratitis, punctate D31.4 + 1 2 Nevus, iris H04.55 + 1 2 3 NLDO, acquired/stenosis H55.01 Nystagmus, congenital LENS Q10.5 NLDO, congenital H55.02 Nystagmus, latent H18.42 + 1 2 3 Keratopathy, band H27.0 + 1 2 3 Aphakia H55.03 Nystagmus, visual deprivation H59.01 + 1 2 3 Keratopathy, bullous aphakic H27.11 + 1 2 3 Dislocated/Subluxation lens Q10.0 Ptosis, congenital H49.0 + 1 2 3 Palsy, 3rd nerve H16.29 + 1 2 3 Keratoconjunctivitis, other Z96.1 Pseudophakia H02.41 + 1 2 3 Ptosis, mechanical H49.1 + 1 2 3 Palsy, 4th nerve H16.25 + 1 2 3 " ", phlyctenular H26.49 + 1 2 3 Secondary cataract H02.42 + 1 2 3 Ptosis, myogenic H49.2 + 1 2 3 Palsy, 6th nerve D31.1 + 1 2 Neoplasm/Dermoid/Nevus H26.13 + 1 2 3 Total traumatic cataract H02.43 + 1 2 3 Ptosis, paralytic G51.0 Palsy, 7th (Bell's) H17.1 + 1 2 3 Opacity, central Juvenille/Infantile Cataracts H49.3 + 1 2 3 Palsy, Total H17.82 + 1 2 3 Opacity, peripheral H26.06 + 1 2 3 Combined Forms H49.81 + 1 2 3 Palsy, Kearns-Sayre H16.01 + 1 2 3 Ulcer, central H26.01 + 1 2 3 Cortical/Lamellar/Zonular H02.05 + 1 2 4 5 Trichiasis without entropion Q10.3 Pseudostrabismus H16.04 + 1 2 3 Ulcer marginal H26.03 + 1 2 3 Nuclear B07.8 Viral warts, unspecified PAYMENT: □ CASH H26.04 + 1 2 3 Subcapsular polar, anterior $ □ CHARGE H26.05 + 1 2 3 Subcapsular polar, posterior □ CHECK □ DICTATED: □ SAVE CHART □ SCHED SX: EYES: 1 = RIGHT EYE 2 = LEFT EYE 3 = BOTH EYES | A = INITIAL ENCOUNTER D = SUBSEQUENT S = SEQUELA RESEARCH/STUDIES NEURO/OPTIC NERVE HIGH RISK MEDS SYSTEMIC Q07.8 Anomaly, optic nerve Z79.2 Long term (current) use, antibiotics If this is your only diagnosis, must use H47.21 + 1 2 3 Atrophy, optic (primary) Z79.52 " ", systemic steroids only the E&M codes (don't use Eye Codes) H47.09 + 1 2 3 Asymetry, optic nerve Z79.899 " ", drug therapy F90.9 ADD/ADHD H47.31 + 1 2 3 Coloboma, optic disc *If applicable, also code any therapeutic drug E70.310 Albinism, X-linked Z51.81 H47.32 + 1 2 3 Drusen, optic nerve level monitoring. E70.311 " ", autosomal recessive D33.3 Glioma, optic nerve MISCELLANEOUS E70.318 " ", other G90.2 Horner's Syndrome T74.4XX + A D S Abuse, Shaken Baby F84.0 Autism disorder H47.03 + 1 2 3 Hypoplasia, optic nerve T76.12X + A D S Abuse, suspected L81.3 Café au lait spot G70.00 Myasthenia Gravis, w/o exac Z04.72 Abuse, suspected (ruled-out) G80.9 Cerebral Palsy G70.01 Myasthenia Gravis, w/ exac H54.0 Blindness, both eyes G93.5 Chiari malformation D33.3 Neoplasm, optic nerve H54.11 Blind RT, Low-va LT Q87.0 Craniofacial, Apert/Goldenhar/Moebius D35.2 Neoplasm, pituitary gland H54.12 Blind LT, Low-va RT Q75.1 Craniofacial, Crouzon H46.0 + 1 2 3 Neuritis, optic (papillitis) H54.41 Blind RT, WNL LT Q75.4 Craniofacial, Treacher Collins H46.1 + 1 2 3 Neuritis, optic retrobulbar H54.42 Blind LT, WNL RT Q75.0 Craniofacial, stenosis H47.01 + 1 2 3 Neuropathy, ischemic optic H47.61 + 1 2 Blindness, cortical H90.5 Deafness, sensorineural H47.11 Papilledema, high ICP H44.52 + 1 2 3 Blindness, hypotensive eye R62.50 Developmentally Delayed G93.2 Pseudotumor cerebri + 1X 2X E10.9 Diabetes, Type I (w/o complication) S05.1 Contusion, eye R29.891 Torticollis, ocular + A D S E11.9 Diabetes, Type II (w/o complication) RETINA/VITREOUS H53.45 + 1 2 3 Defect, visual field (peripheral) Z79.4 Diabetes, Insulin Dependent Q14.8 Coloboma, retina H53.53 Deficit, color (deuteranomaly) Q75.1 Dysostosis, craniofacial H35.41 + 1 2 3 Degeneration, retina (lattice) H53.8 Disturbance, blurred vision Q90.0 Down's Syndrome H44.2 + 1 2 3 Degenerative, myopia (malig) H53.16 Disturbance, psychophysical R48.0 Dyslexia H33.01 + 1 2 3 Detachment, retina (single) H53.19 Disturbance, subjective G40.822 Epilepsy spasms, infants H33.02 +
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