Do you consider a dilated fundus exam to be part of a routine exam? Do you dilate every patinet you see? Or...
Do you schedule the patient for a subsequent visit for the DFE?
For insurance purposes we prefer to schedule dfe on subsequent date which allows us to bill for 2 visits. Some consider this double dipping. Seems like good business sense to me.
What codes do you use?
Dfe should be part of routine exam.....my wife was never given one , just refracted, and she had toxo which has taken away her vision as an adult. Her family was paid very well for this missed part of the exam on the docs part. Just saying if the patient doesnt come back for the dfe, who is responsible for the care of the eye? And I do believe that you are double dipping if you are having the pt return to the office for just a dfe. Hope that all your patients return for the second procedure and your Doc doesnt get put in a sticky liable issue.
And the industry wonders why it is held in such contempt by the general public...Some consider this double dipping. Seems like good business sense to me.
As long as the insurance companys will continue to pay for a second visit for DFE then yes by all means it makes good business sense to do it. As long as all is above board and legal.
Now if insurance does not pay for it then by all means to protect yourself from a liable situtation and in the name of good patient care then DFE should be done EVERY visit. Patient should want it done for their own good and the Dr should want to do it just to keep himself out of the pockets of the attorneys.
If you are doing a routine exam (ie: using routine diagnosis codes 367.xx), the DFE should be included and is considered part of the exam (codes 920XX). Only when you are submitting medically (ie: you have a medical diagnosis, like 361.XX - retinal detachment) should you submit a separate line, in which case DFE would be 92226.
And the industry wonders why it is held in such contempt by the general public...
Thanks Mike. Your response was very helpful.
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