Medicare and most commercial insurances cover annual glaucoma screenings for high-risk individuals. These include: While these are the groups that the Medicare glaucoma screening codes G0117 and G0118 are targeting, most but not all of this group will probably have other ocular complaints or problems that will justify a complete exam which will include all the components of a glaucoma screening exam. "Medicare criteria is specific when it comes to the specific circumstances for coverage of the glaucoma screening G codes and documentation would need to be supportive of screening policies when reporting these codes," warns Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, president of Maggie Mac-Medical Practice Consulting in Clearwater, Fla., and Brooklyn, N.Y. "Patients with co-morbidities will typically require a more comprehensive evaluation and the service will be more than just glaucoma screening, hence resulting in an E/M or eye code for reporting." Example:
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Visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/glaucoma.pdf to read more on Medicare's glaucoma screening guidance.