Retinal Health Screening with Ocular Coherence Tomography
The level of sensitivity of ocular coherence tomography (OCT) devices currently on the market is extremely high. OCT used for screening aims to identify very early signs of eye and systemic disease that may first appear in the retina and that may not be visible to traditional forms of ophthalmoscopy or photography.
Screening is part of a wellness program to check for disease that may otherwise go undetected. It is not required by medical necessity; it is optional. The eye care professional recommends the test prior to a complete eye exam for all patients unless they decline. A technician performs the test before the patient is examined.
This FAQ addresses the following:
- Why consider using ocular coherence tomography (OCT) for screening?
- What is the primary reimbursement issue associated with an OCT screening program?
- How does the reason for the test relate to reimbursement?
- When a physician utilizes OCT for screening consenting patients, who is responsible for payment?
- If a screening test reveals pathology and additional tests are ordered, would they then be covered by insurance?
- What should we tell patients about screening tests?
- What type of waiver form do we ask the patient to sign?
- How should we track the screening service in our computer billing program?
- May we repeat the screening test?
- What documentation is required in the patient’s medical record?
- Since the test is non-covered as screening, are our charges limited by Medicare?
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