CMS 2011 Conversion Factor Update for Ophthalmology

[DOCTORSAIB]

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CMS released it's 2011 update on conversion factor and RVUs for common ophthalmic procedures.

So let me get this straight, the common office visit codes starting with "99" are being reduced as are reimbursement for intravitreal injections.

Is cataract surgery reimbursement going to increase slightly?

http://www.ascrs.org/emails/www/2011%20Medicare%20Physician%20Fee%20Schedule%20-%20Payments.pdf

 

[Visionary]

CMS released it's 2011 update on conversion factor and RVUs for common ophthalmic procedures.

So let me get this straight, the common office visit codes starting with "99" are being reduced as are reimbursement for intravitreal injections.

Is cataract surgery reimbursement going to increase slightly?

http://www.ascrs.org/emails/www/2011%20Medicare%20Physician%20Fee%20Schedule%20-%20Payments.pdf

Yes, intravitreal injections took a huge (~36%) hit. Imaging (OCT) was also significantly reduced, primarily because you will no longer be able to bill per eye. The overall reimbursement is decreased less than a buck, but making it a bilateral procedure will hurt. That drops reimbursement nearly in half for those patients on whom you perform bilateral OCTs. The original 92135 code has been replaced by separate codes of ant seg, ON, and retina. The ant seg code pays a little less than the others.

My read on the visit codes is that the only one that's dropping is, strangely, 99213. The other codes (those which we tend to use) are increasing. I tend to use E/M to a degree, but mostly eye codes. The eye codes are all increasing, albeit only $2-4. Yes, cataract surgery is getting a boost, as well as vitrectomy.

 

[orbitsurgMD]

CMS released it's 2011 update on conversion factor and RVUs for common ophthalmic procedures.

So let me get this straight, the common office visit codes starting with "99" are being reduced as are reimbursement for intravitreal injections.

Is cataract surgery reimbursement going to increase slightly?

http://www.ascrs.org/emails/www/2011%20Medicare%20Physician%20Fee%20Schedule%20-%20Payments.pdf

I can't verify it yet, but on Sermo it has been circulating that the director of CMS (Don Berwick) issued an administrative order for an "emergency" across-the-board reduction of the conversion factor by 7.8%, public notice released on 29 December, 2010, despite Congress' 13-month delay in imposing the scheduled 25% cut imposed by the SGR.

 

[Visionary]

I can't verify it yet, but on Sermo it has been circulating that the director of CMS (Don Berwick) issued an administrative order for an "emergency" across-the-board reduction of the conversion factor by 7.8%, public notice released on 29 December, 2010, despite Congress' 13-month delay in imposing the scheduled 25% cut imposed by the SGR.

That would, indeed, be terrible.