Specialty billing
Ophthalmology medical billing
Ophthalmology carries two parallel code sets and two kinds of payer. Choosing wrongly between them is the specialty's most common billing error.
Book a Free ConsultationWhat we handle for ophthalmology practices
Eye exam codes, diagnostic imaging and medical versus vision plan billing.
Eye codes and E/M
Whichever set fits the encounter and pays appropriately for the work done.
Medical versus vision
Claims routed to the medical or routine vision plan according to the reason for the visit.
Diagnostic imaging
Imaging billed within its coverage frequency limits.
Intravitreal injections
Drug units, wastage and the injection procedure billed together.
Common pitfalls
Where ophthalmology claims go wrong
These are the errors we look for first when reviewing a practice in this specialty. If any sound familiar, a billing review will tell you what they are costing.
- A medical eye condition submitted to a routine vision plan, or a refraction submitted as medical.
- Imaging repeated more often than coverage policy allows.
- Post-operative visits billed inside a surgical global period.
Other specialties we support
Not sure where your revenue is leaking?
Book a free review. We will look at your recent claims, denial patterns and A/R aging, and tell you what we find — whether or not you work with us.