Physician Office Ophthalmology Explained for Students (Easy Guide)
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What This Question Is About
This question relates to physician office ophthalmology and requires a structured academic response.
How to Approach This Question
Break the problem into smaller parts and analyze each logically.
Key Explanation
This topic involves physician office ophthalmology. A strong answer should include explanation, application, and examples.
Original Question
Outpatient—Physician’s Office (Ophthalmology) Patient Name: Mary Shelby Diagnoses: Advanced atrophic macular degeneration with subfoveal involvement, left eye; advanced atrophic macular degeneration, right eye A 72-year-old female, who was referred by her optometrist to an ophthalmologist, arrived for her 11 a.m. appointment on April 1. The ophthalmologist is a specialist in retinal-vitreous surgery, and they discussed with the patient treatment options for visual changes in her left eye. The patient had noticed gradually worsening Amsler grid changes and central vision distortion since January. Visual acuity, blood pressure, slit lamp exam, tension, biomicroscopy, optical coherence tomography, and fluorescein angiogram studies were performed. The studies revealed loss of visual acuity of the left eye, blood pressure within normal limits, persistent central pigment epithelial detachment, trace fluid and hemorrhage along the nasal foveal margin, and prominent perifoveal indistinct drusen of the left eye. Upon completion of the level 4 E/M service, the physician informed the patient of the diagnoses of advanced atrophic macular degeneration with subfoveal involvement of the left eye, and advanced atrophic macular degeneration of the right eye. They discussed the FDA-approved intravitreal injection of Lucentis for this condition. Because the patient had transportation provided for her return home and a primary caregiver in the home, both eyes were treated with intravitreal injections of Lucentis, 0.1 mg, and follow-up evaluation was scheduled in 2 weeks. Instructions: Assign ICD-10-CM, CPT, and HCPCS level II codes for this case. ICD-10-CM: , CPT: , , HCPCS: ,
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