Hello, I was so pleasantly surprised that this topic was reflected here. I hope you will review the following and honestly/candidly let me know if proceeding with the following protocol (still in the discussion phase only) is acceptable for our coding of this new drug. BTW: We are a large optometry/ophthalmology group.
(1) Until insurances get a foothold on ways to cover Presbyopia treating drops (or decide not to cover due to the medication be elective and not a necessity) we will be charging patients a cash pay medical exam.
(2) For a previous patient that has a current Rx for glasses the plan would be to have them come in for a evaluation of pupils (photopic/scotopic), basic vision and IOP check, a full dilated fundus exam and making sure the patient does not have any allergies to the medication per Vuity prescribing information.
a. Exam would be billed as a 99213
(3) Patient would then return to clinic for a quick follow up in 3-4 weeks again with chief complaint and HPI's, checking pupils, basic vision and IOP.
a. Exam would be billed as a 99212
(4) If a patient is at the office for a routine vision/contact lens exam a discussion can begin on talking a little about the product and finding out if they would like to have further work up and evaluation to try the medication. a. Patient would then return to clinic at earliest convenience for the 99213 work up/exam.
(5) If patient has a current pair of glasses or contact lenses but their provider does prescribe Vuity. a. Code would of course be new patient 99203.
Your expertise, insight (and wisdom) would be greatly appreciated.
Best,
Diana Walp
CPC, COPC, CPMA