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How will ICD-10 Impact Optometry Billing Services?

How will ICD-10 Impact Optometry Billing Services?

Everyone seems to be waiting with bated breath for October 1, when finally the ICD-10 will be implemented. With over 68,000 codes, all the specialties will have their financial, clinical, and functioning productivity affected. Optometry too will face revenue loss if claims are not filled in accurately or follow-ups are not done correctly. Optometry especially can be a taxing job and now for sure with the switch to ICD-10 where accuracy in billing and coding will be more important than before.

While the increase in codes may seem formidable, much of the increase is due to the bilateral eye diagnosis codes. With ICD-10 most eye care diagnosis will be reported by eye or eyelid. Specificity is another major issue to be dealt with since more codes imply more specific details. Several organizational tasks need to be executed for ICD-10 like having a training program, reworking fee tickets, updating software, etc.

For Optometrists, the use of ICD-10 codes will require mentioning if a condition relates to the right, left or both eyes. Most eye care physicians are not making an effort to follow ICD-9 coding concepts which will affect in their preparation of the ICD-10 coding system. Each ICD-10 CM code consists of 3-7 characters where the first is an alpha character, the second is a number, and the rest either of the two.

In order to address the regulatory healthcare requirements, Optometric clinics can hire a new team and provide rigorous training to them in ICD-10 coding and billing. Although this is an effective process, financially it is not a feasible option. Procuring the required software and conducting workshops which is labor-intensive can shoot the costs.

For billing, the following are some of the optometry medical services:

  • Eye disease treatment
  • Oral medications
  • Laser surgery procedures
  • Lens prescription for improved vision

Training staff and upgrading systems in order to be ICD-10 compliant can be an expensive affair and a time-consuming one too. Outsourcing your billing cycle to relied billing partners will not only leave you stress-free but will also help you witness an increase in your revenue and have you turn your complete focus on practicing your profession.

FAQs

1. What is the significance of ICD-10 for optometry practices?

ICD-10 introduces over 68,000 codes, including more specific bilateral eye diagnosis codes, making accurate coding essential for optometry practices to avoid revenue loss.

2. How will ICD-10 affect optometry billing and coding?

Optometrists must now specify whether a condition affects the right, left, or both eyes, increasing the complexity and specificity of billing and coding processes.

3. What challenges do optometrists face with ICD-10 compliance?

Optometrists need to update software, rework fee tickets, and provide staff training, all of which can be costly and time-consuming, but necessary to avoid claim denials.

4. Can optometrists manage ICD-10 transitions in-house?

While it’s possible to hire and train a new billing team, this can be expensive. Outsourcing billing to specialized partners is a more cost-effective solution.

5. How can outsourcing billing help with ICD-10 compliance?

Outsourcing ensures accurate ICD-10 coding, reduces errors, and improves revenue, allowing optometrists to focus on patient care without worrying about billing complexities.

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