Billing Scenario 1

In August, a 26-year-old patient presented to Dr. Pasquale with red irritated eyes and was diagnosed with acute conjunctivitis. You billed Alberta Health Care Insurance Plan a B900 with diagnostic code of 372.0. In November, the patient returns to see Dr. Pasquale with the same symptoms, and this time the diagnosis blepharoconjunctivitis.

What would the claim look like?

Billing Scenario 2

Patient was referred to retinal specialist Dr. Janice with floaters and flashes to rule out retinal detachment. Patient was seen in Dr. Janices private office during normal office hours and full retinal assessment was completed, including OCT imaging and B-scan to rule out pathology.

What would the claim look like? (6 marks)

Billing Scenario 3

Patient was referred to retinal specialist Dr. Janice with floaters and flashes in the right eye to rule out retinal detachment. Patient was seen in Dr. Janices private office during normal office hours and full retinal assessment was completed, including OCT imaging and B-scan to rule out pathology. Patient was examined and retinal detachment was ruled out, but retinal tear was found in the right eye and was treated with laser retinopexy to the right eye by Dr. Janice on the same day.

What would the claim look like? (6 marks)