Outpatient Surgery Magazine

Marking Madness - April 2013 - Subscribe

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/122240

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Page 34 of 157

OSM560-April_DIGITAL_Layout 1 4/5/13 2:28 PM Page 35 CODING & BILLING Stephanie Ellis, RN, CPC How to Bill for Premium IOLs Medicare has strict rules about billing patients for the difference. W hen a Medicare cataract patient requests a premium intraocular lens instead of a standard IOL, Medicare lets you charge him the difference between what $1,000 OUT OF POCKET Medicare allows you only a modest markup of $25 to $50 above the IOL cost for the handling of premium IOLs. Medicare reimburs- Here's how to correctly charge a Medicare patient for a premium IOL. es for use of a regu- Premium lens cost Medicare reimbursement for regular IOL lar IOL ($150) and the actual lens cost. Surgical facility's cost for handling of IOL Final suggested maximum amount you can charge patient $1,100 - $150 $950 + $50 $1,000 But billing patients for the difference, surgical centers must follow certain rules to stay in compliance with Medicare guidelines. Here's what you need to know. Premium lens special rules These premium lenses — CrystaLens, ReSTOR and ReZoom presbyopia-correcting lenses and the toric astigmatism-correcting IOL — are A P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 3 5

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