Ophthalmology and Optometry Coding Alert

Now 4 at-risk groups qualify for G0117

In 2006, you need to ask one more question to determine whether a patient is eligible for Medicare's free glaucoma screening: Is the patient a Hispanic 65 years old or older?

CMS has extended the benefit to that group for services reported on and after Jan. 1, 2006. Medicare reimburses for glaucoma screenings for beneficiaries in high-risk groups. Those eligible for the screening now include:

• People with a family history of glaucoma
• People with diabetes mellitus (250.xx)
• Blacks age 50 and older
• Hispanics age 65 and older.

To receive the benefit--coded with G0117 (Glaucoma screening for high-risk patients furnished by an optometrist or ophthalmologist) or G0118 (Glaucoma screening for high-risk patient furnished under the direct supervision of an optometrist or ophthalmologist)--the patient must also already be a Medicare beneficiary.

Medicare accepts only one diagnosis code for G0117 and G0118: V80.1 (Special screening for neurological, eye, and ear diseases; glaucoma). The screening must also occur at least 11 months after any previous screening.

Learn more: Read glaucoma screening information from the Medicare Web site at http://new.cms.hhs.gov/GlaucomaScreening/.