• Return Exams for Corneal Rehab Prior to Surgery

    Question: Patients return for multiple corneal rehabilitation therapies due to contact lens wear with our optometrist once cataract surgery has been determined medically necessary by one of the surgeons in the practice. Are these exams billable?

    Answer: For most patients, it should not require multiple office exams, as repeat keratometry can be done without an accompanying exam. However, it can be argued that documenting stable keratometry after rigid contact lens cessation for the intraocular lens calculation is standard of care. This is significant work, not typical, and is done to treat an abnormal cornea, which is a separate problem from the cataract.

    If a patient requires contact lens refitting to allow the cornea to gradually return to normal shape, this is billed as the fitting instead of an E/M or eye visit code.

    If the patient has opted for a premium IOL, the above services would be included in the refractive package. If not, the patient may be responsible for any payment of non-covered services that the payer deems refractive.

    Learn more in our cornea module.