August 24 EyeCodingForum Webinar: Medicare for Eyecare

This noon, Central Time, 50-minute Webinar will focus on everything related to Medicare for both optometry and ophthalmology. Click here to order EyeCodingForum Services.  It will be recorded so you can view it anytime. It is an update to our July 2014 Webinar. Medicare is your most important insurance carrier. This is a valuable investment of an hour of your time. We will discuss:

  1. Common diagnostic procedures
  2. The Basics (LCDs, E & M Guidelines, Incident-To Rules)
  3. How to work with Medicare
  4. How Medicare Advantage is different.
  5. Why Medicare is not just one, single agency (jurisdictions)
  6. Co-Management
  7. Understand carrier-specific rules
  8. Office visits (both E & M and 920xx codes)
  9. Documentation requirements
  10. How to  appeal denied claims
  11. Improving your ICD-10 coding.

Nationally, about 75 to 85% of Medicare rules and guidelines are the same. However, there are 12 Jurisdictions in the United States and each one has slightly different rules. Our goal will be to provide both a sound foundation and provide new information from all of them and help you get paid correctly, the first time.

The Webinar is $49.00 for one, $149 for purchase a block of 4 or only $499 for access to the entire EyeCodingForum Training Library of over 40 Webinars (Site License). Click here for a list of all available EyeCare Coding and Billing Webinars.

Jeffrey Restuccio, CPC, COC, MBA
(901) 517-1705

2018 ICD-10 Updates for Ophthalmology and Optometry

Join us noon CST, July 27 2017 for our early look at the new 2018 ICD-10 code additions, changes, and deletions for optometry and ophthalmology. This Webinar is about 50-minutes. In addition to being recorded (watch anytime) we plan on conducting this same Webinar live in August, September and October. Every Eyecare Office must conduct new code training every year. It includes:

  1. New ICD-10 codes for 2018 for Eyecare
  2. Changes to degenerative myopia
  3. Changes to blindness codes
  4. Changes to low vision codes
  5. Other code changes
  6. Deleted codes
  7. Revised codes
  8. Formal ICD-10 coding training
  9. When two codes are required and not just one.
  10. Disease specificity
  11. Exceptions and “Gotchas”

This Webinar is $49 or buy a block of 4 for $149; or purchase the Site License (over 40 Webinars plus the next 12 Webinars for a full year) for only $499. Click on This link to Order EyeCodingForum Services.

Click here for a list of all available EyeCare Coding and Billing Webinars.

Twelve EyeCare ICD-10 Questions to Assess Your Knowledge

In 2017 every Eyecare clinic needs to up their game in terms of ICD10 coding specificity. Remember, you don’t need to outrun the lion, just the 90% of Eyecare clinics who do not take this seriously. That’s how you become a top ten-percent earner in Eyecare [Optimize  Compliance/Maximize Revenue]

If you work in an optometry or ophthalmology office the following questions below will help you assess your ICD-10 coding and documentation knowledge. These are not basic ICD-10 questions but more representative of how accurate coding can help your practice optimize r compliance and maximize revenue. The answers to the questions below are all in the EyeCodingForum ICD-10 recorded video training course.

Please share these with everyone you know in Eyecare:

  1. How do you report a dense cataract?
  2. How do you report a rule-out of a blowout fracture?
  3. How do you report a nasal or temporal pterygium?
  4. Does blurred vision [H53.8] support medical necessity?
  5. In ICD-10 you cannot report wet or dry ARMD by eye (right or left) [True or false?].
  6. How do you report “uncontrolled diabetes Type II” in ICD-10?
  7. Is degenerative myopia [H44.2*] paid on a medical claim?
  8. Which code categories do not have a bilateral (3) option?
  9. How do you know how to sequence ICD-10 codes on the claim form? [What is a good source of this information?]
  10. How do you report bacterial conjunctivitis?
  11. Is refractive amblyopia [H53.02*] paid on a medical claim?
  12. Can the removal a suture, stent, conjunctival concretion removal be coded as a foreign body removal?

Jeffrey Restuccio, CPC, COC
(901) 517-1705

September 15: New ICD-10 changes for Eyecare

This 50-minute webinar was recorded on Sep 15 and is now available immediately. It is only $49. The fee is per clinic. You can watch it anytime and as many times as you want. This Webinar will be specific to ophthalmology and optometry (Eyecare).

It has been four years since the last regular annual update to the ICD-9-CM and ICD-10 code sets. On October 1, 2016 ICD-10 will include over 1,900 new codes including four significant changes to Eyecare codes as well as 800 newly released 2017 ICD-10 injury codes. We will cover not only codes directly related to Eyecare as well as those peripherally related. Making even a small mistake can lead to significant denials and revenue losses for your practice.

  1. New ICD-10 codes for 2017
  2. Formal ICD-10 coding training
  3. When two codes are required and not just one.
  4. Changes to open-angle glaucoma codes.
  5. Changes to diabetic retinopathy codes
  6. Changes to macular degeneration codes.
  7. Changes to central and branch retinal vein occlusions
  8. Disease specificity
  9. Exceptions and “Gotchas”
  10. Coding accidents and injuries

Be prepared. Don’t let the insurance companies deny your claims and reduce your income. If your coders and providers have not had comprehensive ICD-10 coding training (at least six hours) you will not be able to fix this in just one or two hours after Oct. 1. It takes training, periodic audits, reviews and continued training and monitoring.

This Webinar is included in our Site License or order a bundle of four for a 50 % discount. If you have any questions please be sure to send them to us beforehand:

Click here to Order.

Aug. 18 Webinar: Coding and Billing for post-cataract glasses

This 50-minute webinar will be held noon central time on Thursday,  Aug 18. It is only $49 and will be recorded so you can watch it anytime. This Webinar will be specific to ophthalmology and optometry (Eyecare).

This webinar will include numerous rules and guidelines concerning reporting services to the DME-MAC, or durable medical equipment, Medicare administrative contractor. It will cover eyeglasses, contacts and prosthetic eyes. This unique niche is either loved or hated by Eyecare professionals. Many have given up due to the increased paperwork and complexity. However, it is a valuable niche market if you have an optician or sales staff that is comfortable upselling patients on additional features.  This is an updated 2016 version from the EyeCodingForum comprehensive billing and coding course. In this webinar you will learn:

  1. What is DME-MAC?
  2. Basic reporting guidelines
  3. Specific HCPC codes
  4. How to streamline the process
  5. Upselling
  6. Marketing your services
  7. Carrier-specific rules
  8. DME-MAC modifiers
  9. Other supplies
  10. Tying it all together

This Webinar is included in our Site License or order a bundle of four for a 50 % discount. If you have any questions please be sure to send them to us beforehand:

Click here to Order.

May 19 Webinar: Winning Carrier Appeals the First Time

This 50-minute webinar will be held noon central time on Thursday,  May 19. It is only $49 and will be recorded so you can watch it anytime. This Webinar will be specific to ophthalmology and optometry (Eyecare). It will include:

  1. Most common reason claims are denied
  2. Top Ten Medicare Part-B reasons
  3. Sample Denial letters
  4. Appeal Steps
  5. Get Organized before you call
  6. Identify the Carrier / Gather the manual or LCD.
  7. Is this a non-covered service?
  8. Is pre-authorization always required?
  9. ICD-10 Linking
  10. NCCI Edit?
  11. Correct Modifier?
  12. Is this a Carrier-Specific Rule?
  13. Is this worth appealing? Can you win?
  14. Contacting the carrier
  15. Appeal as many times (levels) as necessary to get paid.
  16. The art of appealing a denied claim.

This Webinar is included in our Site License or order a bundle of four for a 50 % discount. If you have any questions please be sure to send them to us beforehand:

Click here to Order.

Jan 28 Webinar – Coding Compliance for optometry and ophthalmology

This EyeCodingForum Webinar was on ThursdayJanuary 28, noon central time, fifty-minutes. It is now recorded so you can watch it anytime.

This is an updated version and consolidation of numerous Webinars we have conducted in the past. But it is the first one focused entirely on coding compliance for optometry and ophthalmology. In my 20-plus years of consulting this is the one topic most organizations allow to slip through the cracks–plus it is the most difficult to implement internally because you must be strict with the doctors and there is often pushback.

We will cover:

  1. Basic concepts of coding compliance with an emphasis on Eyecare issues.
  2. Specific examples and areas to focus on.
  3. Office visits
  4. Diagnostic tests
  5. Surgical procedures
  6. Performing a weighted-average analysis of top services
  7. The audit/train/audit feedback loop.
  8. The 12 top compliance errors.
  9. Why baseline training for the staff and providers is necessary.
  10. The features of a good coding compliance plan.
  11. A review of an actual coding compliance plan.
  12. Why implementing good compliance measures will take far less time than you think.
  13. The concept of risk assessment and how much risk your clinic wants to assume.
  14. How improving compliance will improve your bottom line.
  15. And of course your questions.

Click Here to Order the Webinar Now.

Each Webinar is $49 or buy a block of 4 for $99; they are included with the Site License (over 44 Webinars and ICD-10 updates for a full year) for only $499. Click here for a list of available Webinars.


Priority Question and Answer Service for coding, billing, and documentation questions

This support service will use a formal Ticket System plus include a  searchable Knowledge-Base (KB), organized by category with hundreds of the most common Eyecare coding and billing questions. The goal is to answer all posted questions within 24 hours. The KB will be available 24X7. Most questions should be answered the same day, during normal business hours (M-F, 8-5).

Until the end of October, you can test out the system below. You can view over 75 of the most common questions in the knowledge-base without creating a user ID.

After Nov 1 if you wish to test the system send us an email on our contact form and we will set you up with a temporary ID. You have a coding question, post it and then you will be notified of a response within 24-48 hours.

This Priority Q and A service is available for only $25 per month or free toall EyeCodingForum:

  1. Site License clients ($499 per year)
  2. ICD-10 Comprehensive Coding Course clients ($275 until Oct 1 2016).

Remember just one paid claim or coding question solved could pay for the service for an entire year.


Jeffrey Restuccio, CPC, COC, MBA
Coding Specialist in Eyecare

ICD-10 Coding Exercises for Eyecare – 125 Questions

The EyeCodingforu has been posting ICD-10 coding exercises for Eyecare on our website the last two months. The attached document is the latest version with 125 coding exercises. Most, but not all of the answers, are on the 4-page cheat sheet. This document replaces all other ICD-10 coding exercise lists.

ICD-10 Coding for Eyecare Oct 1 2015 125 Questions

Use whatever method you’ve chosen to select codes:

  1. Cheat sheet
  2. Lookup program (Practice Management, ERM, or third-party)
  3. Coding from the manual.

Of course coding from the manual is the only way to ensure accurate, specific, and compliant coding. These questions will help you identify GAPS in your current knowledge and coding system and whether you may need additional training. After entering your codes on Thursday and Friday you might want to scan this list for codes used less frequently. The top 20% are easy. It’s best to become familiar with the less common codes before you have a busy day and then a half-dozen conditions you’ve never coded before. In addition there are bunch of exceptions and “gotcha’s” as I called them in ICD-10. Most took many months of study to find.

The answer key is available to all ICD-10 and Site License subscribers. The ICD-10 training will be updated several times with carrier-specific feedback and is good for one year from purchase.

Articles posted on the include definitions of mild, moderate and severe glaucoma stages, low and high risk glaucoma, the updated definition of “active treatment” for the “A” extender code, and much more.

Workers Compensation and ICD-10

While healthcare providers and physicians may be scrambling to get ready for ICD-10, workers’ compensation practitioners are not required to switch to the new codes, according to the Workgroup for Electronic Data Interchange (WEDI), an advisor to the Department of Health and Human Services.

Approximately one-half of the Workers compensation claims systems are ready to switch to ICD-10 on October 1. About one-half, or 26 states will continue to use ICD-9 codes after Oct. 1 2015. Therefore your PM system will have to support switching between ICD-9 and ICD-10. Plus you staff has to be well-trained to avoid any confusion.

[Also: ICD-10 checklist: AHA releases step-by-step preparation guide]

WEDI has released data on worker’s compensation readiness by state. Twenty-one states have adopted ICD-10 billing for physicians, hospital inpatients and outpatients, according to WEDI.

ICD-10 ready: Alabama, California, Florida, Georgia, Hawaii, Idaho, Illinois, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Ohio, Oregon, South Dakota, Texas and Washington.

Three states have adopted ICD-10 codes for hospital inpatient billing only: Indiana, Maine and South Carolina.

[Also: With ICD-10 about a month away, healthcare providers say ‘bring it on’]

Continue with ICD-9: Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, Hawaii, Iowa, Kansas, Kentucky, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Dakota, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Utah, Vermont, Virginia, Wisconsin and Wyoming.

If you hear anything different please email me at and we will update this post.