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Revascent RCM Webinar Series

Coding Clarity for Ophthalmology Services: Billing, Retina Injections and Compliant Use of Modifier 25

When:

  • Aug. 12, 2025
  • 1 PM ET/ 12 PM CT/ 11A MT/ 10A PT

Who Should Attend:

  • Ophthalmology administration staff
  • Coders
  • Auditors
  • Billing Professionals
  • Compliance Officers
  • Revenue Integrity Analysts
ABOUT THIS WEBINAR
Billing for ophthalmology and retina services requires precision and compliance, especially in light of recent regulatory scrutiny from the OIG. RevascentTM revenue cycle experts will provide in-depth guidance about accurate coding, documentation and modifier use specifically for retina and general ophthalmology services.
We’ll focus on proper use of Modifier 25 when billing E/M services on the same day as intravitreal injections. This is an area under heightened OIG scrutiny; according to its May 2025 report, the agency identified a 92% error rate and nearly $124 million in Medicare payments at risk for non-compliance. 
Key Topics: 
  • Learn more about OIG’s May 2025 report and best practices for compliant billing of E/M with Modifier 25 on the same day as injections
  • Understand the decision-making process behind billing separate E/M services and how to document clearly when procedures are performed during the same encounter
  • Implement correct coding for retina injections, including HCPCS drug codes, bilateral procedure modifiers and linking diagnosis codes to support medical necessity
  • Navigate CMS rules and payer policies for diagnostic testing (e.g., OCT, fluorescein angiography, fundus photography), including frequency limitations and required documentation
  • Interpret status indicators, MUEs and MAIs in the context of ophthalmology to proactively mitigate claim edits and denials
Presented By:
  • Jessica Whitney, CPC, CPMA, AAPC Approved Instructor
    • Revascent VP of RCM, Quality & Education

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