Wiki IOL billing in ASC setting

[charliemarz]

Specific to the ASC setting, for Medicare billing - looking to see how folks are billing for IOLs. The regulations seems to say Medicare does not want the regular IOL reported, only the specialty IOL should be reported/billed. Is this how everyone is billing Medicare and all other payers? If so, does your cataract procedure fee include the cost of the regular IOL?

Thanks in advance

 

[thomas7331]

The regulations seems to say Medicare does not want the regular IOL reported, only the specialty IOL should be reported/billed.

This doesn't sound correct to me - what regulation are you referring to? If it's that the lens has a payment status indicator N1, that doesn't mean it shouldn't be reported, it's just that the payment for it is included in the rate calculation for the procedure. You would still need to report the charge for the IOL as it's not a bundled item.