Vision QA

My husband went to the ophthalmology office for routine eye exam. He told the doctor the primary reason for visit is need a prescription for new pair eyeglass. When the doctor bill to the insurance, they used code for medical eye exam and refuse to submit service as routine eye exam. Because during the exam doctor find pinguecula “a type of conjunctival degeneration in the eye. It is extremely common and it is most prevalent in tropical climates and is in direct correlation with UV exposure” My question is: can doctor bill this service as medical eye exam? How is an eye exam classified as routine or medical? Is base on the purpose of the exam, not the findings?

yes because technically it was a medical eye exam.... an ophthamologist is a medical doctor so an exam he does is considered a medical exam... if your husband would have gone to an optometrist, which is not considered a medical doctor, then the exam could have been billed as a routine eye exam