Article Date: 1/1/2001

Coding Q & A
Insights into accurate coding from a nationally known expert.
By John McGreal, JR., O.D.



When are carriers instructed to update their coding system to reflect changes made in the Current Procedural Terminology (CPT)?

Answer: I know, you just got familiar with the old codes and now they went ahead and changed some of them on you. Unfortunately, every new year equals more changes in the coding system. So I guess this probably means you'll be spending some of your free time researching the changes that will affect you.

Medicare has implemented the revisions to the Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS) to reflect the 2001 updates. The HCPCS 2001 codes are effective for dates of service beginning January 1, 2001.

HCFA has granted a 90-day grace period to allow you adequate time to make these changes. You may bill a 2000 code for a 2001 date of service until March 31, 2001. This will give you some time to research the new codes to see which changes you may want to make to your superbill and computer system, and to train your billing staff.

During this grace period, HCFA will pay all deleted codes using the applicable 2001 payment methodology. On or after April 1, if you bill a 2000 HCPCS code for a 2001 date of service, HCFA will deny the claim. Don't use a 2001 HCPCS code to bill for a service performed in 2000.

I recommend that all practitioners purchase a 2001 CPT book as well as an International Classification of Diseases (ICD-9) book. Once you've studied the common codes used in eyecare, you may find that a revision of your office's superbill and computer system is in order. Also take a look at the 2001 Medicare fee schedule and implement any changes in your charges for the upcoming year.

I learned recently that we need a signature-on-file form in all of our patient records. What is the purpose of this form?

Answer: I'm sure more than a few of you have your patients sign a signature-on-file form. For those who don't, let me tell you, it's a great way to add some convenience to an already hectic system of billing. You can save a lot of time by just having your patient sign the form at her first visit. From there on out, every time you see the patient, you can bill the insurance carrier without her signature.

A signature-on-file form is simply a document that payers allow offices to use, which authorizes doctors to file claims that accept assignment from the insurance companies or other third parties on behalf of the patient. Once a signature-on-file form is part of the patient's medical record, your office may submit claim forms without an original signature from the patient on the claim form itself.

Medicare accepts a lifetime signature-on-file form, but often, commercial carriers accept only a 1-year signature-on-file. It's best to check with each individual carrier to determine the company's requirements for the signature-on-file form, and then update the form as needed. OM

If you have a coding question you'd like answered, send it to Larisa Hubbs, c/o Optometric Management, 1300 Virginia Drive, Suite 400, Ft. Washington, PA 19034. E-mail

Dr. McGreal is center director of the Missouri Eye Institute, a VisionAmerica Co-Management Center in St. Louis. He also lectures on clinical and practice management topics.

Insurance Signature on File

I certify that the information given by me in applying for insurance and/or Medicare payment is true and correct. I authorize my doctor to act as my agent in helping me obtain payment of my insurance and/or Medicare benefits, and I authorize payment of these benefits directly to [Doctor's Name] on my behalf for any services and materials furnished. I authorize any holder of medical information about me to release to the Health Care Financing Administration and its agents any information needed to determine these benefits payable to related services. If I have other health insurance coverage (as indicated in Item 9 of the HCFA-1500 claim form or electronically submitted claim), my signature authorizes release of the above medical information to the insurer or agency shown, and authorizes my doctor to act as my agent, as above.

Lifetime Patient Signature______________Date______


Optometric Management, Issue: January 2001