Covered or Noncovered? The Cataract Menu – Review of Ophthalmology

What Medicare covers is not always clear-cut. A breakdown of cataract surgery and the rationale for who pays what.

This article answers the following questions:

• Does Medicare cover all items and services associated with cataract surgery?
• Which items and services associated with cataract surgery are covered by Medicare?
• If we perform both an A-scan (76519) and an IOLMaster (92136), may we bill one of the tests to the patient as a noncovered test?
• Does Medicare cover anything else associated with cataract surgery?
• If diagnostic tests are performed in the postoperative period after cataract surgery, are they covered by Medicare?
• Are Medicare beneficiaries required to sign an ABN before receiving any non-covered items or services?
• Are there diagnostic tests that may be offered to cataract patients that would be considered noncovered by Medicare?
• Are there any noncovered charges for evaluation and treatment of astigmatism at the time of cataract surgery?
• Are there any noncovered charges associated with patients considering pseudophakic monovision?
• Does the patient get to decide whether to have these noncovered tests?
• Are there any noncovered services associated with conventional IOLs within an ambulatory surgery center?
• Does the patient benefit from having these noncovered tests and services?

This article was published in Review of Ophthalmology’s Medicare Q & A column, which is written by Corcoran’s Vice-President, Donna McCune, CCS-P, COE, CPMA. To view the entire article in Review of Ophthalmology, click on the link below:

http://www.revophth.com/content/d/medicare_q___and___a/c/30938/