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Thesis

Coding and billing manual for Pacific University College of Optometry clinics

1 May 2004

Abstract

The purpose of this manual is to provide the clinic staff, attending doctors, and students of Pacific University College of Optometry with a basic outline of how to bill some of the more common eye care procedures. This manual will also summarize the general process of billing insurance while pointing out some of the differences between some of the major insurance carriers in which Pacific University College of Optometry is a participant. Examples of claim forms are provided along with a list of some of the more-difficult-to-find diagnosis codes. As the realm of insurance billing and coding is vast and ever changing, this manual is not intended to be all-inclusive or stand the test of time, but will hopefully point the reader in the right direction and provide helpful tips to avoid claim denials. Consultation visits, ElM level determination, vision therapy billing, and low vision billing will not be covered in this manual. Even though most students and attending doctors may not be directly involved in the submission of insurance claims, it is important for all to understand the process and the ramifications of improperly coding procedures and diagnoses for reimbursement.


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