Article

CLINICAL: Contact Lenses

Urgent Medical Eye Care

Do you provide and promote urgent eye care services?

Far too often, patients visit their local urgent care center for eye conditions. However, these patients are best treated and cared for by their eye care professional.

It happens even with very loyal patients. They simply do not realize their optometrist could solve urgent eye conditions. That is where optometrists need to do better by educating the patient on our ability to prescribe and treat urgent conditions at a high level.

CASE IN POINT

A 10-year-old new male patient presents with a red, painful right eye. He thinks he scratched it while running around in the backyard when his friend threw a stick. The incident happened earlier in the day.

Slit lamp exam reveals a linear corneal abrasion (see images).

Linear corneal abrasion in 10-year-old.
Images courtesy of Dr. Jason R. Miller.

TREATMENT AND CODING

The treatment plan will include prescribing antibiotic eye drops and, most likely, a bandage contact lens. The bandage contact lens will protect the injury during the healing process and prevent mechanical irritation of the affected area. A bandage contact lens does not provide any healing effect to the site. The proper procedure code for this bandage lens would be 92071-RT. There would also be a service code (9200X or 9920X) for this new patient encounter.

The fitting of the bandage contact lens for ocular surface disease is actually what the procedure is defining. The supply code of the contact lens may be billed separately, however, Medicare identifies 99070 as always bundled with the associated procedure code (92071-RT in this case), so there is no separate payment for the bandage contact lens. Many third-party carriers do not reimburse for the lens.

On the other hand, if the abrasion was deeper, larger or was more centrally located, the clinician may determine the patient is better served with an amniotic membrane. The coding is a little different for that. Instead of using 9200X or 9920X and 92071-RT, these codes would be replaced with only one code: 65778, the procedure code describing the “placement of amniotic membrane on the ocular surface for wound-healing; self-retaining.” The reimbursement for that code includes the office visit related to the decision to perform the procedure/surgery.

RESULTS

For this case, a bandage contact lens was the most appropriate treatment. When the patient returned for his follow-up appointment, the bandage contact lens was removed and the abrasion was almost fully healed after two days.

As a result of internal advertising, the young man’s parents, who were patients of mine, knew I provided urgent medical eye care. They were able get their son’s problem solved quickly and efficiently. Specifically, the parents noted a sign in the front window, but hold messaging, social media and website marketing also can be utilized. Additionally, when such cases arise, consider obtaining a photo release from the patient and using it as a case study on social media to demonstrate urgent medical eye care services at work.

Maximize your ability to provide, and bill for, urgent medical services, as they have the potential to strengthen patient loyalty and practice health. OM