Coding for Refractive Error After Surgery – Review of Ophthalmology

Fixing errors after cataract surgery may be as simple as prescribing lenses, but coding the procedure may prove tricky.

This article answers the following questions:

  • What are the treatment options for patients with refractive errors after cataract surgery?
  • What is considered clinically significant anisometropia?
  • At what point is surgery warranted to correct anisometropia?
  • What types of surgical procedures are typically performed to correct anisometropia?
  • Will Medicare reimburse for these surgical procedures?
  • What is the best way to code these procedures for claim submission?
  • May these procedures be performed as well as reimbursed in an ambulatory surgery center?
  • If our claim is denied do we have any recourse?
  • How often are these surgeries filed to Medicare?
  • What are the options for pseudophakic patients who desire an improvement in accommodation?
  • If the patient is paying for a refractive procedure, are we required to file a claim with Medicare?
  • When the procedure is considered refractive, are the fees limited to Medicare’s allowable or limiting charges?
  • If the surgeon owns the ASC, must we segregate the ASC charges from the professional charges?
  • What are the 2011 Medicare reimbursement rates for these procedures?

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:


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