Ophthalmology and Optometry Coding Alert

Question: A Medicare patient came in just to have his prescription updated. If I only performed a refraction, how should I code? Should I even bother submitting the claim to Medicare? Arkansas Subscriber Answer: Regardless of whether a patient is on Medicare, if you perform -- and charge for -- a refraction (92015, Determination of refractive state), you should code and submit a claim for it. It is not mandatory and you are not required to send a non-covered service claim to Medicare for processing; however, many patients will insist the claim be sent in order to obtain a denial for submission to a secondary plan or because they want to see for themselves that the service is non-covered by Medicare. If the patient insists you submit the claim for a non-covered service, you are obligated to do so. If you do not charge separately for refraction, as many optometrists don't, Medicare [...]