5 Key Takeaways

• 1

  Millions are affected by dry eye disease, requiring regular monitoring and appropriate coding for Evaluation & Management or eye exam services.

• 2

  Diagnostic tools for dry eye include questionnaires and lab tests, but not all are billable; providers must verify coverage before billing.

• 3

  Medicare prohibits blanket non-coverage for Category III codes, requiring individual determinations for claims related to these codes.

• 4

  Treatment for dry eye varies by patient; step therapy is recommended, starting with artificial tears and progressing as needed.

• 5

  Accurate documentation and communication with patients about coverage are essential, especially when using forms like the Medicare ABN.