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: