tci Outpatient Facility Coding Alert - 2017 Issue 9

Reader Question: Avoid Medicare Compliance Traps When Billing for Premium IOLs

Question: Our ambulatory surgery center performs cataract procedures. Sometimes surgeons insert premium IOLs, and I've heard they're a Medicare compliance risk. What can I do to help my ASC lower that risk? Indiana SUbscriber Answer: For more than ten years, we've had guidelines for how ASCs should handle premium IOL billing for Medicare beneficiaries, but there are also lots of confusing misinformation floating around, so it's a good idea to make sure your ASC's billing staff knows the rules. Some misinformation comes from ill-informed supply reps, experts warn. Good rule of thumb: Never believe coding or billing advice from...

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