Wiki How to bill for Bandage Lens ... a fun scenario!

[schaunarae]

I have an OD who sees a patient with recurrent erosion of the RT cornea due to trauma as a child. H18.831. She is also legally blind in that eye and has a mature cataract as well. She has been coming every two weeks to get her bandage lens removed and a new one put in. He is using Acuvue Oasys 8.8 plano BCL OD

He suggested prescribing a 6 weeks' worth of them for her to place on her own at home to save her time and money from coming in every two weeks. Please advise on the correct way to bill this out? Currently we have not been billing materials, just the OV with the BCL fitting code. Patient has BCBS for insurance.

THANKS!

 

[Cheezum51]

Bill 92071. The lens price is bundled into that minimal fee. You can't bill an OV charge with that. Best way to do this would be to bill insurance for the placement and, since you're using a designated BCL product, have the patient pay for a box out of pocket, since those lens incur a cost for your office.

A suggestionerhaps your doctor should trying placing an amniotic membrane on the eye to see if that will resolve the problem once and for all. You may need to get preauthorization from her insurance to do that.

Tom Cheezum, OD, CPC, COPC