tci Part B Insider - 2006 Issue 12

OPHTHALMOLOGY: Reader Question--Prepare Cataract Patients To Bear Cost When Requesting PC-IOL

Question: After cataract surgery, an ophthalmologist inserts a Crystalens intraocular lens to correct a Medicare patient’s presbyopia. Can I code for the physician’s services and supplies?California Subscriber Answer: The answer is yes, but here’s an important exception that you need to keep in mind. Medicare typically covers the insertion of a conventional, clear IOL to replace the cataract-stricken lens that the ophthalmologist removes. In May 2005, Medicare ruled that cataract patients who request a presbyopia-correcting (P-C) IOL, such as the Crystalen or AcrySof RESTOR lenses, can have them--if they are willing to pay the extra...

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