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52 S P E C I A L E D I T I O N 2 0 1 5 • O P T O M E T R I C M A N A G E M E N T . C O M code, thus, are not billable to the pa- tient or a carrier. With that in mind, it is imperative for you and your medical record to meet compliance standards, as there are fundamental principles that must be met. • Medical Necessity: It is incum- bent upon the physician to dem- onstrate the medical necessity of each and every test you perform on a patient. Simply put: Te medi- cal record must clearly demon- strate that the service, procedure or test ordered and performed was absolutely necessary in order to diagnose, treat or monitor the treatment of the individual pat- ient's condition. • CPT Guidelines: As we all know, HIPAA requires us to all follow the rules of the CPT, not just looking up the code. We are expected to know the characteristics of each code as well, including unilateral or bilateral, physician supervision, requirements of the interpretation and report, etc. Te CPT also requires you to always use the code that most closely repre- sents the service that has been per- formed with the patient, not based on reimbursement. Te CPT codes are a subset of the broader Health Care Procedural Coding System, or what is known as HCPCS. CPT codes are Level I HCPCS codes. For new technology that is submitted to the American Medical Association, codes are as- signed that haven't yet been approved are designated as Level III HCPCS codes or what is commonly known as a new technology or tracking code. • CCI Edits: Te CCI initiative is the federal set of policies that govern which tests can or cannot be performed on the same date of service based upon the consensus of the CPT, national and local pol- icy edits, national societies guide- lines and standard medical and sur- gical practices. DECODED Innovation in contact lenses and the technologies that allow you to ft them and prepare the ocular surface for contact lens wear is advancing rapidly. Tough the excitement of incorporating new technology into your practice can be all encompass- ing, don't forget that using the tech- nology comes with rules, defnitions and professional responsibility to use and describe it properly. OM JOHN RUMPAKIS, O.D., M.B.A., is founder, president and CEO of Practice Resource Management, Inc., a consulting, appraisal and manage- ment frm for healthcare professionals. Email him at John@PRMI.com, or visit tinyurl.com/ OMcomment to comment on this article. BUSINESS CODING STRATEGIES ticle by John Rumpakis, O.D., M.B.A. Specifcally, the article revealed that HUGE LESSONS A few years ago, I did a retrospective chart review of my multifocal contact lens-wearing patients older than age 50, specifcally looking at the number of ofce visits these patients had for contacts lens fttings and check ups during a one-year period. Tis review revealed that when I ignored DED in my early years of practice, I saw pa- tients from this subset an average of 4.5 times a year. As a contact lens ft- ting can only be billed once a year, I was wasting valuable chair time seeing patients multiple times for free. Once I began treating DED and other forms of ocular surface diseases, such as ocular allergy, however, I decreased the average number of ofce visits to just under two visits per year. In addition, while I realized patients had dropped out of contact lens wear due to ocular dryness, I had no idea just how much of an impact this made on my bottom line until I read an ar- just one contact lens dropout costs $24,000 throughout a lifetime. WHAT ARE YOU WAITING FOR? It's no secret that contact lens sales comprise a signifcant portion of our practice revenue. Tough innovations in contact lens materials and modali- ties have helped to stem the tide of contact lens dropout, we, as optom- etrists, have a part to play as well. Tis means making a point of diag- nosing and managing these patients to improve contact lens comfort and increase wear time. Te contact lens companies can't do it alone. OM JOSH JOHNSTON, O.D., F.A.A.O., practices at Georgia Eye Partners. He focuses on ocular surface dis- ease and has extensive experience in comanaging cataract and refractive surgery patients. Email him at drj@gaeyepartners.com, or visit tinyurl.com/OMcomment to comment. Continued from p. 37 THOUGH INNOVA- TIONS IN CONTACT LENS MATERIALS AND MODALITIES HAVE HELPED TO STEM THE TIDE OF CONTACT LENS DROPOUT, WE HAVE A PART TO PLAY AS WELL. CLINICAL ANTERIOR