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Practice Management

Congress was able to block a pay cut for physicians who serve Medicare patients. Even though the American Society of Cataract and Refractive Surgery (ASCRS) and the American Academy of Ophthalmology (AAO) are pleased for the delay in the pay cut they maintain that the hard work is just beginning.

The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.

The aging baby-boom population will make eye care a growth industry, resulting in ophthalmology practices adding new physicians. Examine whether the practice really needs to add another physician, avoid overcompensating new hires, and negotiate an associate's buy-in as a partner carefully.

The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.

Some ophthalmologists have suggested applying the non-covered services concept, as stated in CMS rulings 05-01 and CMS-1536-R, to other procedures that alleviate the symptoms of presbyopia, specifically pseudophakic monovision-cataract surgery with IOLs to create monovision.

You, as co-employer, retain full hiring/firing authority, day-to-day management of your employees, and the normal operation of your practice.

Padua, Italy-Safilo Group has strengthened its presence in Asia by opening a new subsidiary in Korea. Safilo Korea Ltd., with offices in Seoul and controlled 100% by Safilo Group, will start business Jan. 1.

Ophthalmologists should familiarize themselves with the differences between evaluation and management (E/M) codes and eye codes, so that whichever set of codes is used is appropriately documented to ensure proper reimbursement, according to L. Neal Freeman, MD, MBA, FACS, a certified specialist in physician coding.

St. Thomas, U.S. Virgin Islands-When four leading practice management specialists met as a panel recently, the pearls of wisdom they shared encouraged ophthalmologists to be aware of vital aspects of their business, including finances, human resources, and legal issues. The session, titled "Business, Operation, and Legal Pearls," provided physicians and administrators with suggestions on how ophthalmologists can increase efficiency, maximize profit, and avoid pitfalls leading to liability.

Ophthalmologists know that a very large number of patients in general practice, and in many subspecialty practices, present with eye symptoms that are too dry or too wet. These common situations trigger coding issues that must be understood in order to ensure proper compensation for care of this sizable patient group.

Base Curve, licensee for the Carolina Herrera Eyewear and John Varvatos Eyewear collections, now has a home online at www.basecurveeyewear.com. The site was designed as a resource for eye-care practitioners and consumers, and includes current, comprehensive information on both brands.

The use of botulinum toxin by ophthalmologists to treat a variety of disorders has exploded over the past several years. It has highlighted many issues of interest, including off-label use, supply charges, and cosmetic indications. All of these have important implications for coding, billing, and reimbursement.

Some of the most common questions in coding arise when an office visit and a procedure are performed almost simultaneously. For our purposes, "almost simultaneously" will refer to same-day office services for small ("minor") procedures and to previous-day or same-day office services for large ("major") procedures.

Medicare rules regarding multiple procedures have been well-outlined and can be thought of as the standard. Most payers closely follow Medicare guidelines in this area. It is still necessary, though, to check with each individual payer for specific instructions. This is especially true regarding the use of the modifiers as discussed below.

Dorado, Puerto Rico-Make sure that your billing department is aware of common myths associated with ophthalmic surgery billing, so that surgery claims being filed are correct, advised Donna M. McCune, CCS-P, COE, who spoke during Current Concepts in Ophthalmology.

Atlanta-Robertson Optical Laboratories of Columbia, SC, Atlanta (Loganville), GA, and Greenville, SC, is offering its third annual Atlanta Braves promotion, which is being sponsored by Robertson, Carl Zeiss Vision, and Transitions Optical Inc.

San Francisco-Attention to safety, speed, staffing, standardization, simplicity, and suppleness is the key to efficiency and effectiveness in the operating room (OR), explained Bradford J. Shingleton, MD, at glaucoma subspecialty day during the American Society of Cataract and Refractive Surgery annual meeting.

Falls Church, VA-Ophthalmologists can justifiably feel as if they are on an endless treadmill, because forces such as personnel shortages and reimbursement cuts are forcing them to become "more gerbil-like every year," according to William L. Rich III, MD, FACS, secretary for federal affairs, American Academy of Ophthalmology, Falls Church, VA. The way out of this bind involves several strategies, from advocating changes in federal reimbursement policy to improving practice productivity, he said.

Washington, DC-The American Academy of Ophthalmology (AAO) sent a letter to the Centers for Medicare and Medicaid Services (CMS) supporting reimbursement for intravitreal injections of bevacizumab (Avastin, Genentech) in patients with age-related macular degeneration (AMD) whose disease has not responded to other therapies.

Sacramento, CA-Obtaining reimbursement and resources forvision screening seems to be a thankless task with little return.However, there are strategies that can be used to give pediatricvision screening a fair share of the available health-care funds,according to James Bradford Ruben, MD.