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How to Choose Between E/M and Eye Codes for Ophthalmology Medical Billing

Comparing E/M and eye codes
Read Time: 1.5 minutes
Jan 11, 2022

When billing for ophthalmology services, it is important to choose the correct code to use. There are two types of codes that can be used: evaluation and management (E/M) codes and eye codes. In this blog post, we will discuss the differences between these two types of codes and help you decide which one is best for your ophthalmology practice.

E/M Codes Are More Specific

E/M codes are used to bill for all types of medical services including, but not limited to, the eyes. These codes can be used for any type of visit, including initial visits, follow-ups, and consultations. There are several different e/m codes available, and each one is specific to a certain type of visit. E/M codes have been suggested as being easier to defend under audit.

Eye Codes Are More Vague

Eye codes are used to bill for services that are related to the eyes but tend to be vague. These codes can be used for exams, treatments, and procedures. There are also several different eye codes available, and each one is specific to a certain type of service.

Choosing the Right Code

So, which code should you use for ophthalmology billing? The answer depends on what type of services you are providing. It should also take into consideration compliance, medical necessity, and financial optimization.

Choosing the correct code is important for ensuring that your ophthalmology billing is accurate and compliant with Medicare and other insurance providers. If you select the wrong code it could lead to lost revenue for the practice or denial of a claim. If a worst-case scenario were to arise, selecting the wrong code could lead to an audit and potential paybacks. It’s an understatement to say that routinely choosing the right codes is important for the success of your practice.

If you are unsure which code to use, be sure to consult with your billing specialist for assistance. And if you’re looking for more information on ophthalmology medical billing, be sure to check out our other blog posts! We have a variety of resources available that can help you get started in the world of medical billing.

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For informational purposes only.