Practice Management

Alameda, CA-Early indications are that the Ocugene glaucoma genetic test (InSite Vision, Alameda, CA) has the potential of becoming a useful tool in determining the likelihood of glaucoma development or progression in certain patients.

Physicians are faced with the need to document clinical examinations for ongoing clinical care in addition to increasing requirements for billing, as a deterrent against claims of fraud and abuse and for malpractice protection. With the typical medical encounter often less than 10 minutes, only a small fraction of this time can be dedicated for documentation purposes.

Everything has changed since Sept. 11, as we've so often heard. But some things have remained the same.

The Health Insurance Portability and Accountability Act (HIPAA), enacted in 1996, included provisions for simplifying the transaction involved with Medicare claims submission. In August of last year, the first provision was published regarding the standardization of claims via electronic filing.

Ophthalmologists continue to be concerned about decreasing reimbursement for cataract surgery and the increasing nonreimbursed costs of utilizing new technology. I believe, however, that the future for lens and implant surgery is rosy.

Today, when patients come for a visit, ophthalmologists have the discretionof using either the eye codes (92002 to 92014) or the E/M codes in billing.But, when is it truly appropriate to use a certain set of codes for a givenvisit? Unfortunately, there's no one standard. It all depends on the rulesset by the carriers in your state.