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Cataract & Refractive Surgery Combinations – Ophthalmology Management

Modern cataract surgery techniques combine noncovered refractive services with cataract extraction. Surgeons achieve better patient outcomes, with reduced reliance on post-cataract eyeglasses due to reduced residual refractive errors. This month, we will attempt to clarify Medicare rules for services that are not covered.

This article answers the following questions:

  • Does Medicare cover all items and services associated with cataract surgery?
  • When diagnostic tests are performed during the postoperative period, aren’t they bundled with the surgery?
  • But Medicare does cover post-cataract eyeglasses. Please explain.
  • Must a Medicare beneficiary sign an ABN before receiving any noncovered items or services?
  • Are there any noncovered charges for evaluation and treatment of astigmatism at the time of cataract surgery?
  • What other diagnostic tests might be noncovered?
  • Some noncovered services are indispensable to the surgeon. Does the patient choose whether to have them?
  • Are there any noncovered services associated with conventional IOLs within an ambulatory surgery center?

This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:

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