How to maximize Reimbursements

By Anne Dwyer, COMT, OCS

As medical practices face the threat of reimbursement cuts, it is important to use medical coding skills to accurately obtain the amount due for services. Your office staff should be well versed in ophthalmic coding and billing, and should stay current on coding updates.

There are many resources available to help physicians and office staff become knowledgeable in ophthalmic coding. The American Academy of Ophthalmology and the American Academy of Ophthalmic Executives (AAOE) have many coding resource books available, including the Ophthalmic Coding Coach, and the Ophthalmic Coding Series Kit. These are updated annually, and are an invaluable resource to coding/billing staff. The AAOE also offers coding bulletins and newsletters that offer helpful tips for staff, and offers the CODEQuest Ophthalmic Coding College at various times and locations throughout the year. The American Society of Ophthalmic Administrators (ASOA) also offers a wide variety of coding and reimbursement resources for its members, including coding books, Medicare information and updates, coding articles from the experts, and online training.

Another way to increase coding knowledge is through the Ophthalmic Coding Specialist (OCS) exam. This exam is offered through the AAOE in conjunction with the Joint Commission of Allied Health Personnel in Ophthalmology (JCAHPO). The exam covers 18 content areas, including questions about ICD-9 and CPT guidelines, Evaluation and Management (E&M) codes, eye codes, modifiers, major and minor surgery, and optical dispensing. This is an open-book exam, and the applicant has 10 days in which to complete it. Upon successful completion of the exam, the title of Ophthalmic Coding Specialist is obtained. I found the Ophthalmic Coding Series Kit and the Ophthalmic Coding Coach, along with current ICD-9 and CPT books, to be the best resources for taking this exam.

If you are interested in obtaining the maximum reimbursement possible for your practice, consider membership for you and your staff in AAOE and ASOA. These organizations have excellent information for all aspects of ophthalmic practice management, including coding and reimbursement. Encouraging your staff to take the OCS exam is another helpful way to ensure that your practice is accurately coding and billing for the examinations and surgeries that you are performing.