tci Part B Insider - 2005 Issue 44

OPHTHALMOLOGY: Opt For Accurate OPT Coding With This Advice

Lesions' appearance will affect your claim alternatives Medicare recently changed the conditions for which it finds ocular photodynamic therapy (OPT) “reasonable and necessary.” Double-check your knowledge and make sure you’re on top of what Medicare will--and won’t--pay for.Background: OPT is a noninvasive treatment for age-related macular degeneration (AMD) that relies on the ability of a photoactive drug to destroy the degenerated cells targeted by the laser. Before 2004, Medicare only approved OPT with verteporfin to treat neovascular AMD--362.52 (Exudative senile macular degeneration)--with predominantly classic subfoveal choroidal neovascularization (CNV) lesions.Change: Now, Medicare allows...

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