Advanced Search

Ophthalmology and Optometry Coding Alert

Prepare for $89 Drop in Cataract Reimbursement Next Year

Published on Wed Aug 19, 2009

You'll also see $14 less for some established patient E/Ms. A quick glance at the proposed 2010 fee schedule shows increased relative value units (RVUs) for several ophthalmology procedures. Great news, right? Not so fast: Once you take the cuts to the conversion factor into account, the future's not so bright. Example: In 2009, 66984 (Extracapsular cataract removal with insertion of intraocular lens prosthesis [1 stage procedure], manual or mechanical technique [e.g., irrigation and aspiration or  hacoemulsification]) has 17.71 total RVUs. In 2010, Medicare proposes to give the same procedure 19.33 RVUs. However, Medicare multiplies the RVUs by a conversion factor to arrive at the total reimbursement, and in 2010 the conversion factor may drop from $36.0666 to $28.4061. This will lead to a drop in reimbursement for 66984 from $638.74 (17.71 x $36.0666) to $549.09 (19.33 x $28.4061). For more information on the conversion factor change, see "Fee Schedule [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ophthalmology and Optometry Coding Alert

View All