State specific seminars designed to enhance participants' coding competency
CMS has provided clear guidance to carriers that periocular injections of combined anti-inflammatory drugs and antibiotics (commonly referred to as “dropless” cataract surgery) are never separately payable. Injections are a part of the ocular surgery and are included in the CPT codes used to report the surgical procedure. CMS also warns that physicians or facilities cannot circumvent packaged payments in the HOPD or ASC by instructing beneficiaries to purchase and bring these drugs to the facility for administration.
CMS has reiterated its long-standing policy that corneal tissue is to be paid on a cost basis and not under the Outpatient Perspective Payment System. There have been reports of such facility claims being denied. Facilities should bill separately based on the invoice using HCPCS code. The Academy and the Eye Bank Association of America (EBAA) had requested that CMS reaffirm this policy.
The 2014 incentive payment is 0.5 percent. Visit the PQRS page for the latest updates.
Whether reporting via claims, registry, or cataract group measure, Academy/AAOE has all the resources you need to achieve the incentive payment and avoid future penalties.
The E-Prescribing program retired effective Jan. 1, 2014. Practices no longer need to report G8553 on their claim forms
Many ophthalmologists have ownership interests in ambulatory surgery centers (ASCs). It’s where a majority of ophthalmic surgical cases in the United States are performed. Unlike physician billing, very little information is available about ASC billing that is ophthalmology specific. That need prompted research and development of the ASC module: Complete Guide to Coding which is now available as a free member benefit.
Download the Complete Guide to Coding [PDF 444K].