With more than 3.6 million cataract surgeries being performed annually in the United States, little wonder that ophthalmology services have caught the eye of the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). In fact, the OIG reports that Medicare is vulnerable to fraud, waste and abuse for wet Age-related Macular Degeneration (wet AMD) and cataracts. Moreover, the OIG said that Medicare paid $22 million for potentially inappropriate claims in 2014. With the aging of America's baby boomers, the number of cataract surgeries is expected to rise. And that increase can be expected to have a positive revenue impact your facility along with the potential for increased auditing and takebacks.
This exclusive ICD10monitor webcast will describe to you and your team the audit-prone issues effecting reimbursement challenges in ophthalmology— diagnostic testing which is key to correct coding and reimbursement—but also CCI edits, medical policies and intent, plus the common misuse of modifiers 22, 24 and 25.
Why This is Relevant:
Ophthalmology is difficult to code due to the many components of diagnostic testing, bundling, and documentation issues. Additionally, many coders continue to misuse modifier -24 during the global period, elevating the likelihood of audits and takebacks. This exclusive ICD10monitor webcast will demonstrate the appropriate uses of modifier 24 as well as modifiers 22 and 25.
Here's the Quiz:
Take this quick quiz and see if you and your team, like so many others, struggle with ophthalmology coding.
- Do you know what CCI edits influence the payer policies on diagnostic testing?
- Can you bill an E&M with a -24 modifier during post-op between surgeries?
- What happens when your physician doesn't perform the interpretation and report?
- What is included when I bill a diagnostic test?
From this exclusive ICD10monitor webcast you will…
- Learn about diagnostic testing and which ones are considered bundled;
- Know when and when not to use modifier -24;
- Understand how OIG workplans influence payer policies; and,
- Learn the key challenges in the documentation of ophthalmology.