Medicare exams

[opto2020]

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For all the current ODs, I just wanted to know what the proper way was to bill Medicare for eye exams. To my undertsanding Medicare will never pick up the refraction fee and only cover the medical part of the exam if there is a medical diagnosis. I was told I was wrong at my new job and that it "just depends how you bill it."
Thanks.

 

[orangezero]

Huge topic.

There was an article on the primary eye care news website that explains it pretty good. The brief way you explain it sounds about right. Its somewhat shocking how little some doctors know about proper coding.

http://www.pconsupersite.com/

there is a series of articles accessed by clicking on the green image on the upper left. Its a start.

Going to them with consultant info is a better way than both you and your employer just guessing what is allowed.

Also the 1997 documentation guidelines should help. Dont have a direct link to them.

 

[Ben Chudner]

Also the 1997 documentation guidelines should help. Dont have a direct link to them.

http://www.cms.hhs.gov/MLNProducts/Downloads/MASTER1.pdf