I'm new to billing DMERC for glasses after cataract surgery (just received billing number) and I had a couple questions. I'd really appreciate if someone could take some time to give me some answers. I'm struggling to get solid answers from the DMERC program in my area (Missouri)
A) What kind of 'Basic' Frames do I need to carry? Is there a certain number that I must carry to fulfill their requirements?
B) If the patient chooses a deluxe frame, do I then, at the time of their fitting, charge them the difference between the deluxe and basic frame and, also, the 20% of the allowed on the basic frame. Do I then have them sign an ABN (Advance Beneficiary Notice) for the deluxe frames.
C) Do I need to keep a record of the referring ophthalmologist that did the surgery and a copy of the RX in the patient's record?
D) Is there any Signature on file requirement? Do I need to get permission to bill that way?
E) When I code for the lenses ie...V2203, etc. , do I fill in my normal and customary fees in the boxes or the allowable amounts that Medicare covers.
Is it logistically simpler to just wait to bill the patient until after I know what Medicare is or is going to pay or allow.
Again, thank you for your answers!!!