Ophthalmology and Optometry Coding Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: Should I charge a Medicare patient for a refraction?

Louisiana Subscriber

    Answer: Medicare considers refractions a non-covered service at all times and under all circumstances. The patient is responsible for paying the service. As a non-covered service, refractions don't require an advance beneficiary notice (ABN), but it is recommended that you inform the patient that refraction is non-covered and as such, he or she will be responsible for payment.
 
Regardless of whether a patient is on Medicare, if a refraction is performed, it should be billed. Educate the patient to avoid collection problems. Some groups use inserts in statements, office handouts and flyers in the waiting room.
 
When a patient who had a refraction checks out, charge him or her for it. You are not obligated to file a claim and wait for Medicare to deny it before collecting from the patient.
 
If you perform the refraction in the course of a postoperative visit for cataract surgery, you may collect it or, as a sign of goodwill, include it along with other postoperative care (although you will not get paid for it).