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New feature to offer exercise in coding office visits
Like every health care discipline, optometry has witnessed its share of change over the past decade. On the upside, we are now able to provide a wider range of professional services, thereby better meeting our patients’ needs. On the downside, managed care has dictated that we see more patients each day, thus reducing the time spent on each patient encounter. There’s no doubt that this trend has resulted in every optometrist’s practice being a bit more interesting, challenging, rewarding … and frustrating.
Our frustration, of course, stems from trying to meet — and exceed — the needs of a very diverse patient population in a limited amount of time. In many respects, today’s patient requires specialized testing, complex medical decision making and more education regarding his or her options and alternatives.
We’ve implemented changes
In an effort to address these needs we’ve all implemented changes for increased office efficiencies. We read professional publications and attend continuing education courses to hone our clinical acumen. We embrace the latest technologies for enhanced diagnosis and treatment. Where appropriate, we delegate examination procedures to enhance patient flow.
Unfortunately, just when we believe we’ve achieved a reasonable balance, there arises yet another challenge. This is something that is daunting because it is outside our realm of expertise as well as something that can be difficult to grasp and open to interpretation. And, perhaps most importantly, it is something that is fraught with severe consequences. This challenge, of course, is office visit coding.
Office visit coding a challenge
Yes, gone are the days of two types of office visits – the comprehensive examination and the follow-up. They’ve been replaced by brief, limited, intermediate, extended and comprehensive office visits. How does one decide which level of visit most appropriately reflects a given patient encounter?
Well, it depends … on a lot of variables. The depth of history, number of tests performed, the complexity of medical decision making as it relates to diagnosis, as well as the time spent in patient consultation are all factored into determining the ‘proper’ code. The challenge arises from trying to make these decisions in the midst of a busy day.
Indeed, it sometimes seems as though we spend as much time figuring out the proper code as we do actually examining the patient. And the consequences are significant, as improper coding can result in penalties, fines and expulsion from managed care programs.
New coding feature
With the stakes so high and time at such a premium, how does one become proficient and compliant in office procedural coding? Primary Care Optometry News recognizes that compliance is a very real challenge for many contemporary optometry practices. Over the past year, we’ve interviewed numerous Medicare coding authorities and have benefited from the expertise of our colleague, Dr. Charles Brownlow.
In our quest to better understand this issue we have asked Dr. Brownlow to analyze and code actual patient encounters from optometry practices. Dr. Brownlow will review patient visits submitted by readers and – depending upon the medical record documentation – recommend the appropriate code. I’m sure all of us will find this exercise interesting, enlightening and essential for continued practice growth.
Send your coding cases to Primary Care Optometry News, 6900 Grove Rd., Thorofare, NJ 08086; fax: (856) 853-5991; e-mail: pcon@slackinc.com. Look for this new feature to start next month.