Third Party Center develops much-needed information package outlining proper vision rehabilitation codingFebruary 26, 2013
Insurance, Vision Therapy, and Neuro-Optometric Rehabilitation, a new information package from the AOA Third Party Center, offers long-sought guidance on proper coding and billing for vision rehabilitative services, according to authors Harvey Richman, O.D., Jason Clopton, O.D., and Richard Soden, O.D.
“Vision therapy (VT) and neuro-rehabilitation today are often used to treat specific diagnosed ocular, visual and visual perceptual conditions. In some cases, vision therapy is the only available and effective treatment option for those conditions,” said Dr. Richman.
Increasingly, treatment may be covered under major medical or vision insurance plans.
However, many practitioners continue to have questions about the proper way to code VT and neuro-rehabilitation on insurance claims, Dr. Richman notes.
“Inability to properly report these services on claims could mean needless claim rejections and, ultimately, that patients do not receive the care they need,” Dr. Richman said.
The comprehensive new 58-page AOA vision therapy coding package provides an overview of the health care coding system and basic advice on the selection of billing codes, with detailed information on the selection of:
- Examination procedure codes
- Special testing codes
- Follow-up examination procedure codes, and
- Therapy codes.
Extensive information is provided on the documentation necessary to meet coding requirements, and, in particular, the documenting of sensorimotor exams in patient medical records.
A special section focuses on the types of health care providers who are authorized to submit 97000 therapeutic service codes.
The package also provides sample forms and letters to insurance carriers for preauthorization requests, responses to requests for additional information, and responses to denied claims.
Dr. Richman and his coauthors encourage practitioners to appropriately code services for all vision therapy and neuro-rehabilitation patients, even when insurance reimbursement will not sought, as mean of ensuring consistency in patient records and encouraging mastery of coding procedures.
AOA members can access the “Insurance, Vision Therapy, and Neuro-Optometric Rehabilitation” information online at Insurance Vision Therapy and Neuro Optometric Rehabilitation(AOA Approved 1-31-2013) branded_v2.