You Be the Coder:
Is Refraction for Medicare Patient
Published on Tue Jan 01, 2002
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Should I charge a Medicare patient for a refraction?
Louisiana Subscriber
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Answer: Medicare considers refractions a non-covered service at all times and under all circumstances. The patient is responsible for paying the service. As a non-covered service, refractions don't require an advance beneficiary notice (ABN), but it is recommended that you inform the patient that refraction is non-covered and as such, he or she will be responsible for payment.
Regardless of whether a patient is on Medicare, if a refraction is performed, it should be billed. Educate the patient to avoid collection problems. Some groups use inserts in statements, office handouts and flyers in the waiting room.
When a patient who had a refraction checks out, charge him or her for it. You are not obligated to file a claim and wait for Medicare to deny it before collecting from the patient.
If you perform the refraction in the course of a postoperative visit for cataract surgery, you may collect it or, as a sign of goodwill, include it along with other postoperative care (although you will not get paid for it). | |
