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  • Cataract/Anterior Segment Coding Competency Ask the Expert

    Co-management With Nonparticipating Optometrist


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    When the referring optometrist’s office does not participate with a medical plan, are surgeons allowed to globally bill for cataract surgery and have the optometrist submit invoices for their co-managed portion to the surgeon for payment? 

    Answer:
    If an optometrist does not participate with the insurance, they cannot provide co-managment. Each party independently bills for the appropriate number of post-op days they provide. Payments from the surgeon to the optometrist may be viewed as a violation of federal anti-kickback statutes.

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