Prepayment Reviews of Ophthalmic Tests
Published on: 4/13/2012
Ophthalmic Diagnostic Tests are to be the subject of prepayment review for Palmetto Medicare. The reviews will be conducted in Jurisdiction 11, including providers in North Carolina, South Carolina, Virginia and West Virginia. The focus of the reviews will be:
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· 76514
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Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral determination of corneal thickness
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· 92002
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Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program: intermediate, new patient
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· 92004
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Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program: comprehensive, new patient, one or more visits
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· 92012
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Ophthalmological services: medical examination and evaluation with initiation or continuation of diagnostic and treatment program: intermediate established patient
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· 92014
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Ophthalmological services: medical examination and evaluation with initiation or continuation of diagnostic and treatment program: comprehensive, established patient, one or more visits
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· 92015
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Determination of refractive state
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· 92020
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Gonioscopy, separate procedure
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· 92083
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Visual field examination unilateral or bilateral, with interpretation and report: extended examination (e.g., Goldman Visual Fields with at least three quantitative, automated threshold perimetry, Octopus Program G-1, 32 or 42, Humphrey Visual Field ANA
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· 92225
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Ophthalmoscopy, extended with retinal drawing (e.g., for retinal detachment, melanoma) with interpretation and report: initial
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· 92226
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Ophthalmoscopy, extended with retinal drawing (e.g., for retinal detachment, melanoma) with interpretation and report: subsequent
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· 92235
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Fluorescein Angiography (Includes multiframe imaging) with interpretation and report
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· 92250
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Fundus photography with interpretation and report
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· 92285
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External ocular photography with interpretation and report for documentation of medical progress (e.g., close-up photography, slit lamp photography, goniophotography, stereo-photography)
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The complete text of this announcement, including instructions for preparing and sending the documents can be obtained from the Palmetto website at http://www.palmettogba.com/palmetto/providers.nsf/ls/jurisdiction%2011%20part%20b~8t9nz80035?opendocument&utm_source=j11bl&utm_campaign=j11bls&utm_medium=email