Practice Management Consulting for
Ophthalmology & Optometry
Corcoran Consulting Group specializes in coding and reimbursement issues for ophthalmology and optometry practices.
Listen to Our Newest Ophthalmic Reimbursement Podcast — your trusted source for clarity in coding, billing, and compliance.
In a field where precision matters and regulations are constantly evolving, we’re here to help you stay informed, confident, and ahead of the curve. Whether you're a practice administrator, coder, or ophthalmologist, this podcast delivers expert insights, practical strategies, and timely updates to support your success in today’s complex reimbursement landscape. Let’s decode the details together — one episode at a time.
Innovation Beyond Drugs: Devices, Tissue Products, and ASC Reimbursement
Ophthalmology Reimbursed is celebrating one year! In this special anniversary episode, we look back at some of the conversations, industry perspectives, and reimbursement issues that shaped our first year and look ahead to what’s coming next, including an invitation to connect with the Corcoran Consulting Group team at AAO in New Orleans.
Then, we wrap up our Beyond the Bundle Series by shifting the focus from drugs to devices, tissue products, and ASC reimbursement. We break down what may be separately payable, what is typically included in the ASC facility payment, how device-intensive procedures fit into the picture, and what ASC leaders should consider before adopting a new technology. We also discuss the October 1, 2026 implementation of CPT 1084T as a timely example of why coding and reimbursement changes need to be monitored throughout the year.
Join us as we celebrate our first year, close out Beyond the Bundle, and get ready for another year of practical conversations about ophthalmology coding, reimbursement, and compliance.
Listen NowCoding & Reimbursement Specialists
Since 1986, Corcoran Consulting Group has served thousands of physicians in ophthalmic and optometric practices in all 50 states. We offer a variety of coding, auditing, and reimbursement services specifically for ophthalmology and optometry practices. These include customized onsite education, e-learning and webinar training, chart reviews and audits, fee schedule analysis, monographs, FAQ’s and newsletters to support physicians and staff. In addition, clients have access to other products such as a condensed guide for Medicare billing, coverage/payment sheets, and a variety of ophthalmic specific documents for your practice.
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Recent News & Articles
Code Implementation Dates
Last week the AMA published information about several important coding and billing updates that will affect claims submission, and compliance in your practice and ASC. Unexpected October 1st Effective Date The effective date for the several new category III codes, including the following codes for ophthalmic procedures, has been moved up to October 1, 2026.…
Properly Billing for Intravitreal Injections with E/M Code 99211-99215 and Modifier 25
CMS TPE audits of intravitreal injections and the accompanying office visit continue. Practices involved in these reviews often question what auditors are looking for. These reviews focus on the quality of procedure documentation, the medication and associated office visit, as well as the accuracy of the claims for reimbursement. On March 21,2025, a new resource to…
Coding Q&A: Medicare as a Secondary Payer
In certain cases, health care providers must determine whether Medicare is the primary or secondary payer to ensure correct billing and compliance with regulations. Some patients have more than one health insurance plan. A physician’s claim for reimbursement is processed twice: first by the primary insurer, then by the secondary insurer to pay some or…
Coding & Reimbursement: Separate Procedures and NCCI Bundles
Exceptions to restrictions and limitations exist, but understanding the exceptions and modifier usage is crucial. On a regular basis, billers and coders confront a challenge when two procedures are performed on the same day for a patient. Can both procedures be submitted on a claim for reimbursement? Various limitations and restrictions apply, which make the…
Medicare Contractor WPS Incorporates ASCRS/AAO Recommendations on Proposed Local Coverage Determination for Cataract Surgery
Medicare Administrative Contractor (MAC) Wisconsin Physicians Service Insurance Corporation (WPS) released its final version of the LCD. In this edition, WPS brings the proposed LCD closer to current practice trends in same-day bilateral cataract surgery, also known as immediate sequential bilateral cataract surgery (ISBCS). WPS removed the limitations on same-day bilateral cataract surgery in the…
Coding and Reimbursement: What’s New in 2024?
Find out what changed in coding and reimbursement this year and how it affects your ophthalmic practice in this article by Corcoran Consultants Mary Pat Johnson and Brandy Sperry, which appeared in the July/August issue of Administrative Eyecare. Topics covered include changes in the following areas: CPT Codes ASC Quality Measures HSC and HOPD Reimbursement…
iDose New Permanent J code
In December 2023, the US Food and Drug Administration approved iDose TR for a single administration per eye intracameral implant that continuously releases travoprost, indicated for the reduction of intraocular pressure in patients with ocular hypertension or open-angle glaucoma. The Centers for Medicare and Medicaid Services has assigned a unique, permanent HCPCS J-code for iDose TR (Glaukos). The…
Federal Trade Commission Eyeglass Rule
Concluding a comprehensive multi-year review, the Federal Trade Commission (FTC) has announced final updates to its Ophthalmic Practice Rules, known as the Eyeglass Rule, aimed at promoting competition and consumer choice. According to the FTC, the updates are designed to increase compliance with the rule’s long-standing requirement that ophthalmologists and optometrists provide patients with a free…
Coding & Reimbursement: Part C Medicare vs Traditional Medicare
We can expect enrollment in Medicare Part C, or Medicare Advantage (MA), to continue its two-decade long trend of growth. According to the Kaiser Family Foundation (KFF), MA enrollment in 2023 was 30.8 million or 51% of eligible beneficiaries.1 The Congressional Budget Office estimates that enrollment will rise to about 61% of eligible beneficiaries by…
Coding: Should You Perform More Laser Trabeculoplasty?
There are far more eligible patients than those who are receiving therapy. Not infrequently, an ophthalmologist or optometrist receives a critical letter that informs the recipient that their utilization rate for a procedure is higher than the norm. The letter implies that the procedure is performed too frequently and perhaps unnecessarily. Unfortunately, there is no…
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