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Ophthalmology/Optometry

  1. Default Ophthalmology/Optometry
    Medical Coding Books
    Are the ophthalmologist and optometrist considered the same speciality if both are memebers of the same group for defining the 3 year rule of new and established pt.?

    Thanks you,
    Caroline

  2. Default
    Please any thoughts?

  3. #3
    Default
    Yes. I wld think so.
    Tiger, CPC, CEMC, CPMA

  4. Default
    Thank you for your response!

  5. Default
    Sorry for the late response. I hope it will still be helpful.

    Optometry and Ophthalmology are NOT the same specialty. Never.
    Whether they're in the same group or not. Even if they share the chart, even within 3 years. Not the same specialty.

  6. Default Optometrist Billing New Patient
    We have an optometrist in same practice as our ophthalmologists-

    I understand the optometrist can send a patient to an ophthalmologist and the ophthalmologist can bill a new patient. However, can an ophthalmologist in same practice refer a patient to our optometrist and the optometrist can bill a new patient also? Different Taxonomies.

    So the Rule I have is:

    OD to OD 3 year rule applies

    OD to MD 3 year rule does not apply- MD can bill New Patient

    ? MD to OD what rule applies?

    Thank you for your responses.

  7. Default
    They have to be of the exact same specialty and subspecialty for the 3 year rule to apply.

    Therefore, an OD to OMD referral is new to each provider if pt hadn't been seen in practice by OD before.

    OMD to OD is new to both if above applies.

    General OMD to retinal specialist in same practice would be new for both (different subspecialties)

    general OD to low vision OD in same practice could also be new to both due to subspecialties being different.

  8. Default
    Thank you for your feedback, greatly appreciated.

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