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Increased use of ophthalmic tests results in increased scrutiny
WAILEA, Hawaii — Among ophthalmic tests, use of immunoassays more than doubled in the past year.
Use of these tests, such as Quidel’s InflammaDry MMP-9, increased 118%, from approximately 36,000 procedures to 79,000 procedures and resulted in increased audits and decreased reimbursement, according to Kevin J. Corcoran, COE, CPC, CPMA, FNAO.
“So, if you are doing a ton of this testing, be aware,” Corcoran said at Hawaiian Eye 2018.
In ophthalmic imaging, even though the increase in percentage of OCT scans done in association with retinal injections is relatively low, only 9% in 1 year, the number of injections is “really big,” some 6 million, he said. Furthermore, the increase over a span of years for retinal imaging has “gone through the roof,” while the trajectory of other types of retinal imaging has remained relatively flat, Corcoran said.
“So if you’re doing 6 million events, you get the attention of Congress,” Corcoran said. “Lo and behold, I think OCT of the retina is going to come under fairly heavy scrutiny.”
Use of other ophthalmology tests has similarly increased by large percentages, for example, UBM by 79% and pachymetry by 70%, which may be “target practice for reviewers,” he said.
In the surgical area, iStent use is up 47% and use of temporary amniotic membrane in the office is up 44%, whereas the number of paracenteses and subconjunctival injections have decreased 26% and 46% respectively.
“The single most common procedure of all time” is the intravitreal injection, Corcoran said. Injectable eye drug costs to Medicare totaled more than $3 billion, he said. – by Patricia Nale, ELS
Reference:
Source: Corcoran KJ. What’s new for 2018? Presented at: Hawaiian Eye 2018; Jan. 13-19, 2018; Wailea, Hawaii.
Disclosure: Corcoran reports he is a consultant for Corcoran Consulting Group.