CODING Q & A
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
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
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.
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 firstname.lastname@example.org.
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
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