{"id":1529,"date":"2014-10-06T15:36:03","date_gmt":"2014-10-06T15:36:03","guid":{"rendered":"http:\/\/reviewob.dev\/2014\/10\/06\/dry-eye-meet-growing-patient-needs-and-bill-effectively-for-services\/"},"modified":"2014-10-06T15:36:03","modified_gmt":"2014-10-06T15:36:03","slug":"dry-eye-meet-growing-patient-needs-and-bill-effectively-for-services","status":"publish","type":"post","link":"https:\/\/reviewob.com\/dry-eye-meet-growing-patient-needs-and-bill-effectively-for-services\/","title":{"rendered":"Dry Eye: Meet Growing Patient Needs–and Bill Effectively for Services"},"content":{"rendered":"

David I. Geffen, OD, FAAO<\/h3>\n

\"\"<\/span><\/p>\n

\n
\n
SYNOPSIS<\/h5>\n

Dry eye is increasingly common as America ages. Treating dry eye is a practice-builder\u2014if you plan, code and bill efficiently and effectively.<\/p>\n

ACTION POINTS<\/h5>\n

GEAR UP FOR INCREASED FREQUENCY OFPATIENT VISITS<\/strong>. Mild dry eye patients can be seen just once a year, but severe cases can be seen up to four times a year.<\/p>\n

BILL AS MEDICAL VISITS<\/strong>. Bill dry eye visits as medical visits, and keepservices such as punctal plugs separate charges from office visits.<\/p>\n

EDUCATE DRY EYE PATIENTS<\/strong>. Let dry eye patients know they havea chronic condition that will require long-term, consistent treatment.<\/p>\n<\/div>\n<\/div>\n

In our MD\/OD practice, we have built up a specialtyin providing treatment to patients with dry eye for the last five years. Succeeding in this area requires clinical skills and some adjustments to schedule, as dry eye patients return more frequently. Also, doctor and staff need to be on top of the requirements forbilling and coding dry eye visits as medical eyecare. We also have gotten the word out that we can help dry eye patients. We’ve found that bymastering these elements, we’ve made dry eye treatments a profitable and growing part of our practice.<\/p>\n

On average, we see about 20 dry eye patients per month and generate approximately 5 percent of our income from dry eye-related visits. This is a growing area as we receive more referrals from other patients and doctors. We have grown the dry eye area of our practice by about 10 percent per year.<\/p>\n

Plan to See Patients Up to Four Times a Year<\/h5>\n

The frequency patients are seen by us depends on the severity of their dry eye. Mild patients are seen once per year while moderate patients may be seen twice and the severer patients are seen quarterly.<\/p>\n

Rather than setting aside specific days and times for a dry eye clinic, we’ve found it works best to simply slot dry eye patients into appointment slots designated for medical office visits.<\/p>\n

Bill as Medical Visits<\/h5>\n

We bill the visits as medical visits, and depending on the patient’s insurance, some are cash pay. We separate services such as punctal plugs as separate charges from office visits.<\/p>\n

The billing codes are the same we use for our common medical visits. It is important to get the correct ICD codes for dry eye differential such as keratitis and MGD, or else your practice will not be paid for the visit. As with any office visit you must state the reason for the visit and the chief complaint. It must match the testing done and relate to the diagnosic code. For these patients I use MGD, keratitis, dry eye and the common codes. If you do not do the appropriate testing for the level you are billing, you will not be paid and may be denied.<\/p>\n

Diagnose & Bill<\/h5>\n

Diagnosing dry eye<\/strong>: The diagnosing is typically part of my general comprehensive exam, so the vast majority of patients are billed as a 92004 for a new patient. If the patient comes as a referral from another doctor for dry eye treatment, we bill as an intermediate exam 92002.<\/p>\n

Further evaluations<\/strong>: The typical treatment will involve the diagnosis at the first visit. If there is ample time we do the testing at this visit, but most often we reschedule the patient for a dry eye work up billed as an intermediate exam. At this point it will depend on the treatment and severity of the disease to determine when and how often we will see the patient. For mild cases we often see the patient back in two weeks to evaluate the treatment, and that will be the final visit for a year. Moderate cases are typically seen at one week, then two weeks later, and then six weeks later and six months. Severe cases are seen one, two, four and twelve weeks and then either quarterly or biannually if controlled.<\/p>\n

Treatments<\/strong>: Four visits\/annum. The follow-up visits are typically intermediate visits billed a 92012.<\/p>\n

\nInvest in Needed Instrumentation<\/h5>\n

We use a variety of instrumentation, though the slit lamp remains the primary diagnostic tool. We utilize fluorescene, lisamine green and the zone quick. We have found TearLab to be very useful in diagnosing and monitoring our dry eye treatments. We are considering bringing in Lipiflow, but do not have it at this time. Most of the instrumentation is not any extra cost as we have this in the office anyway. Some of the equipment pays for itself very quickly such as the TearLab. Lipiflow is quite expensive–$70,000 and $350 an eye for the disposables–so you need a large volume of patients to get it. Slit lamp photography is good to show patients what their eyes look like and help to get better compliance.<\/p>\n

\nEducate Dry Eye Patients<\/h5>\n

Most dry eye patients we see have MGD, and I tell them that this is a chronic condition and it will take consistent treatment to keep it from flaring up. I go through the process of treatment and try to explain why we are doing each step. We try to demonstrate the treatments in the office to make sure the patient is doing the treatment the correct way. I believe that follow-up visits are important to ensure that the patient is improving.<\/p>\n

Address Dry Eye in CL Patients<\/h5>\n

Dry eye contact lens patients pose unique complications. Not only do we need to treat the dry eye; we are trying to keep them comfortable in their contact lenses. Fortunately, we have many new contacts to assist us in minimizing their dry eye problems. It is especially important to go over the relationship of dry eyes and contact lens comfort. We currently are offering some artificial tears and supplements in the office to keep our contact lens patients in their lenses.<\/p>\n

Avoid Common Dry Eye Practice Mistakes<\/h5>\n

First, you must look for dry eye problems with your patients. Too often if the patient is not complaining we don’t look for dry eye issues. Second, when you diagnosis dry eye don’t be afraid to reschedule patients for extra testing. We do not need to do everything at the general exam. Charging for these services is important or the patient will not place any value on them and will not comply. Adding things like supplements and tears will add some profitability to your practice, as well as help compliance with your treatment regime.<\/p>\n

Related ROB Articles<\/strong><\/p>\n

Dry Eye Patients: Serve a Growing Population<\/a><\/p>\n

SixStrategies to Grow a Dry Eye Specialty<\/a><\/p>\n

Dry Eye: Treating a Growing Patient Need is Also a Practice Builder<\/a><\/p>\n

Related ROB Videos<\/strong><\/p>\n

Medical Model Opportunity: Ocular Surface Disease and Dry Eye<\/a><\/p>\n

Moisture Chamber Eyeglasses: Relief for Severe Dry Eye<\/a><\/p>\n

Practice-Builder: Treat Ocular Surface Disease<\/a><\/p>\n

David I. Geffen, OD, FAAO, <\/strong>is a partnerin Gordon-Weiss-Schanzlin Vision Institute<\/a><\/strong> in La Jolla, Calif. To contact: dig2020@aol.com<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

By David I. Geffen, OD, FAAO<\/p>\n

<\/strong><\/strong>Dry eye is increasingly common as America ages. Treating dry eye is a practice-builder\u2014if you plan, code and bill efficiently and effectively.<\/p>\n","protected":false},"author":3,"featured_media":1530,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[87,1],"tags":[241],"yoast_head":"\nDry Eye: Meet Growing Patient Needs-and Bill Effectively for Services - Review of Optometric Business<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/reviewob.com\/dry-eye-meet-growing-patient-needs-and-bill-effectively-for-services\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dry Eye: Meet Growing Patient Needs-and Bill Effectively for Services - Review of Optometric Business\" \/>\n<meta property=\"og:description\" content=\"By David I. 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