August 2002
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August 2002
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volume #16
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PRIO DEVELOPS NEW ONLINE COMPUTER LENS SEMINAR
The Computer Vision Care market is taking off in a big way. As a PRIO OD, you understand better than anyone that the best Rx in the right lens is the key to successful eyewear. Which is why PRIO Corporation—the leader in  computer vision care—has developed an ABO-approved online lens seminar that will assist ECPs choose the best lens for your computer-using patients. The course has also been submitted for COPE approval, which is expected by early fall.Currently, many ECPs still use single vision or bifocal lenses for their computer patients. Others are using trifocals or general purpose PALs. For the most part, these lenses are not the best choice for computer users who must see primarily at the midrange, but also need to read printed material and would like as much distance vision as possible. PRIO believes that once your dispenser understands how to fit the new variable focus lenses, with the help of Shazam!, that these will be the "lens of choice" for your computer-using patients. Opticians familiar with our lenses tell us that PRIO computer eyewear has become the easiest second pair sale in their office. These new lenses can be used with just about every patient—from the kid that works on computers at home and in school—to young adults who work all day at a computer—and even to the older user, who is emailing grandchildren or surfing the internet for leisure.
Many labs are already sponsoring this educational lens seminar for their accounts. Call your lab—or call PRIO at -for more information on this FREE online lens seminar. CVS: THIRD PARTY REIMBURSEMENT—Part II
In the June 2002 issue of Insights, PRIO brought to you Part I of an article commissioned by PRIO from Dr. Richard Soden, OD, New York. Part I emphasized that until specific CPT and ICDA codes are created and approved for "CVS" and until there is a uniform agreement that CVS is a true medical anomaly, each practitioner will have to decide how to bill for the signs and symptoms of "Computer Vision Syndrome."According to Dr. Soden, if the practitioner chooses to view CVS as a medical problem, then he/she must follow the same guidelines and rules that he/she follows for other patients and must appropriately document his/her records using CPT and ICDA coding. He/She must also abide by all the laws of the patient's health care plan whether it is Medicare or any other government run program, managed care or any other traditional health insurance plan regardless of whether the practitioner is a participating doctor or not. If the practitioner chooses to consider CVS as an optical problem, then he/she will consider this a "non-covered" service and will bill either the patient or any applicable optical plan for the service. Each practitioner who tests for CVS MUST determine if there is a separate fee for CVS testing. If the practitioner considers CVS to be a medical problem, it may be applicable to include PRIO testing as an incidental test to the medical office visit and not bill the patient nor his insurance company a separate charge nor add on an additional charge to the refraction. If the practitioner chooses to consider CVS to be a pure optical problem, it may be appropriate to add an appropriate charge to the non-covered exam. e) Avoid using "standardized billing practices" such as a person with symptoms of CVS is always "E & M" Level 3 or 4. One final note: Only the doctor should assign the billing code—not the billing staff. f) "E & M" Codes define a level of service and the complexity of the case along with the examination and the history determines which level to bill. A diagnosis itself does not determine which "E & M" code to chose. A dry eye can ultimately be billed with several levels of E & M depending upon the complexity of the case. The THREE KEY factors to be considered when choosing the appropriate E & M Code are: H = History E = Exam M = Level of Medical Decision Making g) EVERY Record should contain the following: Reason for the visit and history — "S" for Subjective in SOAP Examination and Testing — "O" for Objective in SOAP Assessment - What the Practitioner Determines: Data Analysisand Diagnosis — "A" for Assessment in SOAP Plan- what action is taken, treatment, return — "P" for Plan in SOAP h) Documenting and Coding Eye Services Step One: Take history in the proper documentation format
Determine examination indicated by history and properly document findings Step Three: Make a medical decision and properly document your findings based on:
Determine the ICDA-9 diagnosis codes to as specific a level as possible Step Five: Decide on using E/M codes or 92000 codes
For each "E & M" code for an established patient: Two elements at any given level must be met or exceeded to code at that level (see CPT-4 for specifics)
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For more information on PRIO's Complete Computer Vision System PRIO Corporation 8285 NW Nimbus Ave. Suite 148 Beaverton, OR 97008 1- website:www.prio.com email:mail@prio.com |
