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    Question: Upon reviewing the revised Comprehensive Guidelines for Comanagement of Ophthalmic Postoperative Care, one of my colleagues interpreted the phrase "written agreement" to mean that the Academy recommends that the operating ophthalmologist draft a general contract explaining his co-management policy, and that this contract be distributed to and signed by all co-managing providers. However, I interpret the phrase to refer to the well-established CMS requirement for a documented transfer of care with the patient's information, details of surgery, transfer date, etc., that is supposed to occur with every comanaged case. Which interpretation is correct?

    Answer: Your colleague is correct. The ideal documentation suggested in the Comprehensive Guidelines includes written consent between the operating surgeon and the co-managing provider and a document stating that the patient consents to the arrangement. Additionally, the CMS requirements for transfer of care documentation must still be met, independent of the guidelines. Please note that the recommended written agreement is not a requirement enforced by the Academy nor are the guidelines part of the Academy’s Code of Ethics, although Rules 7 and 8 address ethics rules that apply to comanagement and postoperative care.

    For more information, see Rule 7. Delegation of Services, and Rule 8. Postoperative Care, of the Code of Ethics.

    To submit a question to the Ethics Committee, email ethics@aao.org.