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Ophthalmology header art
99%
Ophthalmology

Comprehensive eye care and surgery billing for optometrists and ophthalmologists.

Specialty highlight

99%

Built around payer rules, documentation requirements, and coding nuances.

Cataract Surgery Accuracy

99%

Clean Claim Rate

97%

Overview

Billing in Ophthalmology

A practical view of what makes this specialty unique.

Ophthalmology billing is highly specialized, covering everything from routine eye exams and contact lens fittings to complex anterior and posterior segment surgeries like cataract extraction and vitrectomy. Our ophthalmology billing service is designed for this precision. We ensure accurate coding for all office visits, diagnostic tests, and surgical procedures, including the management of global surgical packages for cataract surgery, maximizing your revenue and allowing you to focus on patient vision.

Accurate coding for comprehensive eye exams and problem-focused visits.

Standardized into our workflow to reduce rework and protect revenue.

Expertise in billing for diagnostic tests: visual fields (92081-92083), OCT (92134), fundus photos (92250).

Standardized into our workflow to reduce rework and protect revenue.

Management of global surgical packages for cataract surgery (66982, 66984).

Standardized into our workflow to reduce rework and protect revenue.

Coding for retinal surgeries (67041, 67108), glaucoma surgeries (65855, 66179), and corneal procedures.

Standardized into our workflow to reduce rework and protect revenue.

Challenges

What slows reimbursement

The common friction points that trigger delays, denials, and rework.

Key challenges
  • Accurately coding for a high volume of diagnostic tests (visual fields, OCT, fundus photography).
  • Managing the global surgical package for cataract surgery and other procedures.
  • Ensuring proper coding for complex retinal surgeries (vitrectomy, scleral buckle).
  • Billing for YAG capsulotomy and other post-cataract laser procedures.
  • Navigating payer policies for premium IOLs and other advanced technology lenses.
Our solutions
  • Certified ophthalmology coders with deep expertise in eye care coding guidelines.
  • Precise coding for all levels of eye exams (92002-92014, 99201-99215) and specialized testing.
  • Expert management of global surgical packages for cataract and other ophthalmic surgeries.
  • Expertise in coding for retinal, glaucoma, and corneal surgeries and procedures.
  • Meticulous charge capture for all in-office diagnostic tests and imaging.
  • Detailed support for YAG capsulotomy and laser trabeculoplasty coding.
Features

Operational features that keep claims clean

Repeatable checks, payer alignment, and tight charge capture.

Accurate coding for comprehensive eye exams and problem-focused visits.

Included to improve first-pass acceptance and reduce downstream edits.

Expertise in billing for diagnostic tests: visual fields (92081-92083), OCT (92134), fundus photos (92250).

Included to improve first-pass acceptance and reduce downstream edits.

Management of global surgical packages for cataract surgery (66982, 66984).

Included to improve first-pass acceptance and reduce downstream edits.

Coding for retinal surgeries (67041, 67108), glaucoma surgeries (65855, 66179), and corneal procedures.

Included to improve first-pass acceptance and reduce downstream edits.

Support for YAG capsulotomy (66821) and laser trabeculoplasty (65855).

Included to improve first-pass acceptance and reduce downstream edits.

Coding

Coding complexities we watch closely

Modifier usage, documentation rules, and specialty-specific payer edits.

Complexity checklist
  • Cataract surgery coding based on complexity (routine vs. complex 66982).
  • Retinal surgery coding distinguishing between vitrectomy, membrane peel, and gas/fluid exchange.
  • Correct coding for YAG capsulotomy within the global period of cataract surgery.
  • Using modifiers for bilateral procedures (-50) and distinct post-op services (-24, -25).
Denial triggers

Incorrect coding for the level of eye exam.

Bundling of diagnostic tests with the exam visit.

Mismanagement of the 90-day global period for cataract surgery.

Coding for YAG capsulotomy without proper modifier or within global period.

Incorrect use of -RT/-LT or -50 modifiers.

Codes

Common codes (examples)

Reference-only examples to illustrate the typical coding landscape.

CPT

92014 (Comprehensive Exam), 66984 (Cataract Surgery), 92134 (OCT), 92083 (Visual Field), 66821 (YAG Capsulotomy)

ICD-10

H25.9 (Cataract), H40.9 (Glaucoma), E11.39 (Diabetic Retinopathy), H35.30 (Macular Degeneration), H52.13 (Myopia)

FAQ

Frequently Asked Questions

Got questions? We've got answers

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