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Ophthalmologists affected by changes in CMS coding
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 Stephen A. Kamenetzky |
DANA POINT, Calif. — Imaging technology across all specialties has come under intense scrutiny for reimbursement re-evaluation, and ophthalmology has not been spared, a physician and speaker for the AAO Relative Value Update Committee said here.
At the American Glaucoma Society meeting, Stephen A. Kamenetzky, MD, OCS, said, "CMS has been given a charge to reduce costs, and whether they care or not is not material."
The Centers for Medicare and Medicaid Services code for optical coherence tomography has been changed from 92135 to 92133. Ultimately, this change means that ophthalmologists will be seeing about half of the reimbursement for this procedure than what they saw in the past. The difference is that a procedure that was once billed for each eye must now be billed for both eyes once.
The change from reimbursement for unilateral OCT to bilateral OCT is $44 per eye in 2010 and $26 for both eyes in 2011 with the implementation of the new code.
The CMS accounts for the same physician time, but practice expenses are reduced, Dr. Kamenetzky said.
"Imaging is going to continue to be driven down, because it's simple and noninvasive. It's tech performed in general, and it's discretionary. CMS and Congress are looking for ways to cut the costs, and this is an easy target," he said.
- Disclosure: Dr. Kamenetzky is a member of the AAO Relative Value Update Committee, but opinions expressed are his own. He is a medical reviewer for Anthem Blue Cross Blue Shield and is on the board of directors of Ophthalmic Mutual Insurance Company.