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:

http://www.revophth.com/content/d/medicare_q___and___a/c/28489/