Ophthalmology Billing That Sees the Big Picture
Between complex surgical bundling rules, vision plan limitations, and ever-changing Medicare policies for eye care, ophthalmology billing requires 20/20 precision. We help practices navigate these challenges—so you can focus on patient vision rather than claim denials.
Last quarter alone, we recovered $214,000 in previously denied claims for a 9-provider ophthalmology group by correcting modifier usage and surgical documentation. But beyond the numbers, we give you back the time and confidence to concentrate on patient care.
Get Your Free Revenue AnalysisComprehensive Eye Exam Coding
We ensure accurate coding for all vision services while navigating these key distinctions:
Routine vs Medical
- 92004 vs 99204 documentation
- Vision plan vs medical billing
Specialty Exams
- Glaucoma workups (92133-92134)
- Diabetic eye exams (92250)
Documentation Tip: For comprehensive eye exams, we ensure your notes include:
✓ Chief complaint ✓ External/internal exam findings ✓ Diagnosis/assessment ✓ Treatment plan
Diagnostic Testing & Modifier Precision
We navigate the complexities of ophthalmic diagnostics:
Imaging Tests
- OCT (92134)
- Fundus photos (92250)
Visual Fields
- 92081-92083 coding
- Frequency limitations
Modifiers
- RT/LT for laterality
- TC/26 for technical vs professional
Pro Tip: We maintain a database of payer-specific policies for ophthalmic diagnostics, updated quarterly.
Surgical Billing Expertise
We handle the nuances of ophthalmic surgical billing:
Cataract
66984, 66982 with IOL
Retina
67028, 67036 injections
Glaucoma
65855, 66174 procedures
Our Surgical Billing Process:
- Verify global period requirements
- Apply correct surgical modifiers
- Document medical necessity
- Track post-op visits
Vision Plan & Payer Credentialing
We streamline enrollment with all major vision and medical plans:
Vision Plans
- VSP enrollment
- EyeMed credentialing
Medical Plans
- Medicare enrollment
- Commercial payer contracts
Our Credentialing Advantage:
✓ Average 45-day turnaround ✓ 100% CAQH compliance ✓ Vision plan fee schedule analysis
"Their team increased our collections for cataract surgeries by 38% by properly applying global period modifiers and documenting complex cases. They also handle all our VSP and EyeMed billing—we no longer have to worry about vision plan claim rejections."
Dr. Sarah Chen
ClearVision Ophthalmology
Ready to Sharpen Your Revenue Focus?
Get a free analysis of your last 90 days of claims. We'll identify your top opportunities to:
- Reduce surgical denials
- Optimize diagnostic testing
- Maximize vision plan revenue