In-depth articles on ophthalmology billing services, eye codes, cataract and retina surgical billing, diagnostic testing bundling rules, and how to maximize reimbursements for eye care practices.
Ophthalmology billing is one of the most technically complex specialties in healthcare, requiring mastery of unique code families, intricate surgical bundling rules, and high-value drug reimbursement mechanics. Eye care practices must constantly choose between the ophthalmology-specific eye visit codes (92002-92014) and general E/M codes (99202-99215), a decision that can impact reimbursement by $20 to $80 per visit. Understanding payer-specific rules for these code families is essential for capturing every legitimate dollar of exam revenue.
Surgical billing in ophthalmology, particularly for cataracts and retina procedures, presents significant revenue opportunities and risks. Distinguishing between routine and complex cataract surgery (66984 vs. 66982), managing 90-day global periods for unrelated conditions, and correctly applying staged procedure modifiers for second-eye surgeries are critical skills for any ophthalmic billing team. In retina practices, the billing of expensive anti-VEGF medications requires precise unit counting, NDC code alignment, and proper use of the JW modifier for drug waste to prevent thousands of dollars in monthly losses. Diagnostic testing, such as OCT scans and visual fields, also carries complex bundling edits and frequency limits that must be managed to ensure full payment.
Medtransic provides specialized ophthalmology billing services delivered by experts who understand the nuances of ophthalmic anatomy, surgical techniques, and payer-specific eye care policies. Our team performs comprehensive code-selection analysis, surgical operative report review, and proactive drug waste tracking to ensure eye care practices achieve peak financial performance. Whether you are a high-volume surgical center or a specialized retina practice, our RCM solutions are designed to stop invisible revenue leaks and maximize your collections.
Need help with ophthalmology billing? Contact Medtransic today. Call 888-777-0860 or visit our contact page.