How Often Can I Test for Glaucoma? – Optometric Management
Date: March 1, 2023
A question that we receive frequently at Corcoran Consulting Group is “How often can I do this test?” Some Medicare contractors and other payors place restrictions on how frequently they expect a test to be performed. Diagnostic testing is warranted when the information garnered from the eye exam is insufficient to adequately assess the patient’s disease.
In general, all diagnostic tests are reimbursed when medically indicated and properly documented. So, if a patient has a history of glaucoma (or another indicated condition) and the eye exam reveals unstable or worsening disease, then more extensive testing may be justified. That said, too-frequent testing can garner unwanted attention from Medicare and other payers, and could lead to an audit.
Here is a list of common diagnostic tests for glaucoma and their expected frequency, based on information published by the CMS and the Medicare Administrative Contractors (MAC).
Published in: Retinal Physician
Written by: Consultant, Brandy H. Sperry, COMT, CPC, COE, CPMA
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