Here are the top 10 billed ophthalmology procedures with the highest denial rates according to a report from RemitDATA. The procedures are ranked from highest to lowest denial rates.
1. 92004: Ophthlamological services: Medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive new patient, one or more visits — 9 percent
2. 66982: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (Eg., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine — 6 percent
3. 92012: Ophthalmological services: Medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient — 8 percent
4. 92014: Ophthalmological services: Medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, one or more visits — 8 percent
5. 92134: Scanning computerized ophthalmic diagnostic imaging, posterior segment with interpretation and report, unilateral or bilateral retina — 8 percent
6. 66821: Discussion of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg., YAG Laser) (1 or more stages) — 8 percent
7. J2778: Injection, ranibizumab, 0.1 MG — 7 percent
8. 67028: Intravitreal injection of a pharmacologic agent (separate procedure) — 7 percent
9. 66984: Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg., irrigation and aspiration or phacoemulsification) — 6 percent
10. J0178: Injection, aflibercept, 1 MG — 5 percent
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