Documenting IVI: Avoiding audit traps – Retina Specialists

In the course of your usual retinal clinic, you undoubtedly perform numerous intravitreal injections. Intravitreal injections are now common to the point that they’re under scrutiny by Medicare and other payers.

It’s somewhat logical for Medicare to be interested in the procedure and associated drugs. In 2018, the most recent for which data are available, Medicare paid providers $2.9 billion for injections of aflibercept (Eylea, Regeneron Pharmaceuticals) and ranibizumab (Lucentis, Genentech/Roche). In 2017, Medicare paid a total of $9 billion to ophthalmologists, with IVI drug expenses accounting for more than 38 percent of that total.  The sheer cost to the Medicare trust fund impels the Office of the Inspector General to carefully monitor physician billing for these drugs.

This article was published in Retina Specialist, which is written by Ellen R. Adams, MBA. To view the entire article in Retina Specialist, click on the link below:

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