Program_Memos / 2001 / B-01-46

Why This Topic Matters

It helps readers understand how Medicare communicated operational requirements for glaucoma screening policy at the time, especially the billing, claims, and patient-notice elements that affect reimbursement and denial processing.

Article Sections

1. Glaucoma screening service codes and type of service

   Introduces the screening service codes and the related type-of-service classification discussed in the memorandum.

2. Frequency and claims system edits

   Summarizes the timing rules described for repeat screening and the planned claims system edits for later dates of service.

3. Claims editing and diagnosis coding requirements

   Covers guidance on claim review practices and the diagnosis reporting expectations associated with this screening service.

4. Payment methodology

   Describes the general Medicare payment approach and mentions standard patient cost-sharing and related charge limitations.

5. Remittance advice notices

   Outlines the claim adjustment messaging referenced for denials tied to coverage timing and billing review.

6. Medicare Summary Notice and Explanation of Medicare Benefits messages

   Summarizes the beneficiary notice language referenced for noncovered or timing-related denials, including the Spanish versions noted in the memorandum.

7. Provider notification and implementation dates

   Addresses distribution to providers, effective and implementation timing, and the disposal timeframe for the memorandum.