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November/December 2016 Optometric Association 921 South 9Th Street, Ste Northern Sights Newsletter North Dakota Vol. 28 Issue 6 November/December 2016 Optometric Association 921 South 9th Street, Ste. 120 NDOA’s 2016-2017 NEWLY INSTALLED BOARD OF DIRECTORS Bismarck, ND 58504 Phone: 701-258-6766 Fax: 701-258-9005 E-mail: [email protected] Website: www.ndeyecare.com 2015 NDOA OFFICERS Dr. Paul Dunderland President President President Elect Vice President Secretary/Treasurer Past President PO Box 169 Dr. Amy DuBois Dr. Darin Johnson Dr. Nate Shilman Dr. Krista Heil Dr. Blaine Burdick Bottineau, ND 58318 701-228-2219 President’s Message ~ Dr. Amy Mitzel-DuBois [email protected] Dr. Blaine Burdick ell….here it is, my first official Director, Nancy Kopp, I am confident we President Elect article for the NDOA will have a successful year supporting our PO Box 888 W newsletter as your President. association and our profession. There are Devils Lake, ND 58301 many issues in the next year that need to be 701-662-2817 I am honored to serve our association as addressed that are vital to the success of our [email protected] President for 2016-2017. A little profession and the protection of the patients background on myself - I am from Valley we serve, Opternative, MIPS, MACRA, and Dr. Amy DuBois City, ND where I attended grade school, Vice President AMP to name a few: I will do my best to high school, and undergraduate at VCSU. I 3232 13th Ave. South promote our profession and our association attended Pacific University College of Fargo, ND 58103 and take on these issues. 701-280-3000 Optometry, graduating in 1998, and I’ve [email protected] practiced in ND for the past 18 years. I live Please feel free to contact me with any in Fargo with my husband, Chad, and our questions and/or concerns you have Dr. Darin Johnson two daughters, Paige and Mya. In my spare regarding actions or events occurring in our Secretary/Treasurer 1525 31st Ave. SW, Ste. E time, I enjoy working in my yard, relaxing association or profession. Minot, ND 58701 at our lake home, and attending my 701-857-6050 children’s sporting events. Inside This Issue [email protected] New Board Members I have learned so much over the past few Past President’s Remarks Dr. Taya Patzman years serving on the NDOA Board, with the Past President help of Blaine Burdick, Paul Dunderland, The Truth About Modifier -25 and Billing a Foreign Body Removal 1830 East Century Ave. Ste. 1 and Taya Patzmann, excellent past Bismarck, ND 58503 presidents I have served with. I do realize I Prescription Drug Monitoring Program 701-222-1140 have much yet to learn in the next year as I [email protected] Thank you for supporting your PAC! serve as your President. State Board of Optometry Candidates Nancy Kopp With the help of my current board members Executive Director and the tireless efforts of our Executive Northern Sights November / December Page 2 Welcome to the New Board! Dr. Blaine Burdick, Past President timeline for each and discussed the support and opposition that G reetings NDOA members! I hope you all are may arise. enjoying this nice fall weather as 2016 is coming Our Board’s plan was to relay what we had learned from Mr. to a close. I’d like to share with you what your Walstad and share the concerns with our State Board prior to NDOA board has been working on over the past their meeting in October. We feel this language is very important few weeks. and will need a cohesive effort of both the NDOA and State Several months ago we agreed to work with the State Board to Board. We will continue to work together to make sure this introduce legislation to further define an eye examination, thus language is well-thought out, timely, and has as little opposition preventing Opternative or other kiosk-type “eye examinations” as possible. from coming into our state. Prior to our board meeting we were Unfortunately, this will be my last newsletter article! It has been informed, based on a recommendation from the State Board’s a pleasure to serve on the board the last five years, which has attorney, that these changes would be made by an administrative been the fastest five years of my life. Serving on the board has rule rather than statute. given me new respect and up-close view of organized optometry. Initially our board questioned the strength of an administrative It has enabled me to meet several amazing people at a state and rule and set up a conference call with AOA’s State and national level who volunteer their time and dedicate their lives as Government Relations Committee. Given our situation, AOA’s advocates for our profession. I will be grateful for many of the recommendations were that an administrative rule would be a relationships that have been formed over the past five years. good starting point, as Opternative is not currently operating in I leave you with a strong board ready to serve its membership. I our state. The NDOA Board also consulted with an attorney, would like to thank Dr. Krista Heil for giving back and John Walstad, who recently retired but has served on the North volunteering to serve on the board. Thank you to all of those who Dakota Rules Committee for the past 27 years. Mr. Walstad continue to make this profession better than you have found it! communicated with us the pros and cons about putting the language in statue vs administrative rule. He also laid out a Thank You Industry Partners Candidates for the State Board of The 113th NDOA Annual Congress was supported in part by promotional grants from the following companies: Optometry Gold Sponsor Johnson & Johnson T he NDOA is asked by the Governor’s Office, to make recommendations, as to candidates to serve on the ND State Silver Sponsor BlephEx, LLC Board of Optometry. The current State Board OD members Essilor Laboratories are: Dr. Jeffery Yunker of Grand Forks, Dr. Jill Martinson- Precision Lens Redekopp of Minot, Dr. Tamera Mathison of Jamestown, Dr. VSP Global Brian Beattie of Bismarck and Dr. Taya Patzman of Bismarck. Corporate Dr. Alan King of Dickinson, serves as Executive Director. Bronze Sponsor Traditionally, the NDOA has forwarded at least two names to ADO Buying Group the Governor. Dr. Jill Martinson-Redekopp’s term expires on Alcon June 30, 2017. Dr. Martinson-Redekopp has indicated she is Walman Optical interested in serving another 5 year term. If any NDOA member is interested for nomination to serve, Congratulations! please contact the NDOA office by February 13, 2017. The members in attendance at the Membership Meeting, Dr. Paul Dunderland tentatively scheduled at the Bismarck Ramkota for March 30- 31, 2017, at our Legislative and Continuing Education “OD of the Year” Conference will vote on the recommendations. Northern Sights November / December Page 3 The Truth About Modifier -25 and Billing a Foreign Body Removal A 34-year-old WM presents to your office with pain of the right A foreign body removal does have a zero-day global period, so eye for the past 3 days. It is red, watering, and photophobic. He if a rust ring removal is performed on another day you can bill was working on his car’s exhaust system a few days ago and his for it at that point. Because the reference material has conflict- eye has been irritated ever sense. You perform a slit lamp exam ing information, it is up to the provider to choose which code t and find a metallic foreign body imbedded in the cornea with a they feel is the most appropriate. If they are ever audited, they rust ring. You remove the foreign body with a 27G needle and would at least be able to say they are aware of the controversy use an Alger brush to remove the rust ring. A bandage contact and explain why they chose the code they did. I know many of lens is inserted and you schedule the patient for a follow up in you are thinking, “But I have billed both of these the same day two days. many times and they have always been paid.” Remember, just because it got paid, does not mean you did it right. Using a dif- ferent diagnosis code for each surgical procedure may get it past How do you code this encounter? the computer system, but an auditor may not be as forgiving. significant, separately identifiable evaluation and Modifier 25 management [E/M] service by the same physician Finally, the bandage contact lens (92071). If a bandage contact on the same day of the procedure or other service lens is used, you may bill for it along with the surgical code… usually. Some payers might consider a bandage CL as part of This is one of the most misunderstood coding situations I en- the wound care that is covered under the FB removal code. But counter, yet most doctors I speak with think they have it figured the majority do not. Another gray area here is that most payers out. The problem we have is that many “experts” have been (like Medicare) bundle the cost of the actual lens with the fee confusing us for many years by giving out information that is paid for 92071. Therefore, you do not bill separately for the ma- incorrect. The first concept we need to understand is that a sur- terials. If the payer does reimburse for the materials, you would gical code includes an office visit.
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