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.
Pass-Through Drugs 101: Understanding the Reimbursement, Compliance, and Quality Impact
In Episode 1 of our Summer Series, learn the fundamentals of pass-through status, current ophthalmic examples, coding considerations, financial implications, and how these therapies intersect with MIPS and value-based care.
This summer, Ophthalmology Reimbursed is taking a deep dive into one of the most important and often misunderstood areas of ophthalmology reimbursement. Join us for our three-part podcast series:
Beyond the Bundle: Understanding Separate Reimbursement for Drugs, Devices, and Tissues in Ophthalmology
As innovation continues to reshape ophthalmic care, practices are navigating increasingly complex reimbursement pathways for drugs, devices, biologics, and tissues that may qualify for separate payment outside traditional bundled reimbursement models.
Throughout this series, our consultants will discuss the opportunities, challenges, and compliance considerations surrounding these payment methodologies and how they impact physician practices, ambulatory surgery centers, and hospital outpatient departments.
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.
Introducing Our New Pricing Structure
Corcoran Consulting Group has recently changed its pricing structure.
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Premium Content Credits
Starting at $500
Medicare Reference Guide
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Resources
Recent News & Articles
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: 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…
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: Medicare Considerations of Compounded Drugs
Billing differs for FDA-approved and compounded drugs. Compounded medications can be beneficial in certain circumstances. This article discusses how they can be billed in a retina practice. How should a clinic bill for compounded medicines? Are compounding pharmacies regulated?
