Breaking News from the ASCRS Meeting in Washington DC

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Eyewire reports on new products and breaking news live from the American Society of Cataract and Refractive Surgery meeting in Washington DC.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Surgical Options for Patients With Cataracts and Open-Angle Glaucoma

Recent studies evaluated the efficacy of MIGS combined with phacoemulsification.

Maxwell de la Paz, BS, and Linda M. Tsai, MD

Cataract and Refractive Surgery Today

Key Takeaways Recent studies have evaluated the efficacy of MIGS combined with phacoemulsification in eyes with open-angle glaucoma. Trabecular procedures combined with cataract surgery provided a greater IOP reduction than cataract surgery alone in patients with hypertensive open-angle glaucoma. Compared to phacoemulsification alone, combining the procedure with MIGS appeared to provide a greater reduction in IOP and the number of medications required postoperatively without decreasing safety. Trabecular Procedures Combined with Cataract Surgery for Open- Angle Glaucoma: A Report by the American Academy of Ophthalmology Richter GM, Takusagawa HL, Sit AJ, et al1Industry support for this study: None ABSTRACT SUMMARY This report compared the IOP reduction of various trabecular procedures combined with cataract surgery to that of cataract surgery alone in patients with hypertensive open-angle glaucoma (OAG). Patient-specific considerations that might guide procedure selection were also investigated. STUDY IN BRIEF A report drawing on 10 randomized controlled trials found that combining trabecular procedures with cataract surgery provided a greater IOP reduction than cataract surgery alone in patients with hypertensive open-angle glaucoma. The trabecular procedures themselves showed no clear benefits over one another for IOP or medication reduction, but direct comparison studies are required. The risks of uveitis and bleeding were among the factors that might influence surgeons’ choice of trabecular procedure. WHY IT MATTERS In patients with well-controlled hypertensive open-angle glaucoma, cataract surgery may reduce their medication burden by 0.8 to 1 at 2 years. When cataract surgery is combined with a trabecular procedure, a further 0.4-reduction may occur.1,2 Because the combined trabecular procedures in this AAO report offered similar benefits, patient factors and surgeon preference may be more important when offering specific options.

Using Category III Codes

Five tips to help improve accuracy, payment, and compliance.

Matthew Baugh, MHA, COT, OCS, OCSR

Retina Today

Accurate coding for emerging retinal technologies requires more than familiarity with the standard American Medical Association (AMA) Current Procedural Terminology (CPT) Category I and Healthcare Common Procedure Coding System (HCPCS) codes; it also requires understanding CPT Category III codes. These temporary tracking codes, or “T” codes, are increasingly common in retina as innovation accelerates, yet they remain a frequent source of confusion, denials, and compliance risk. CPT Category III codes consist of four numeric characters followed by the letter “T.” Although they are valid CPT codes, they do not have assigned relative value units (RVUs) or national Medicare payment rates. As a result, coverage and carrier pricing for reimbursement are determined by the Medicare Administrative Contractor (MAC) or the individual payer. The following five practical tips outline how retina practices can use CPT Category III codes correctly to improve payer outcomes and position emerging services for future CPT Category I promotion. TIP NO. 1: DON’T DEFAULT TO PATIENT PAY A common misconception is that Category III codes are inherently noncovered and should automatically be billed to the patient. However, Category III status does not always mean investigational or noncovered. Rather, when a procedure is best described with a Category III code, it should be billed as such on the claim. Coverage decisions are based on medical necessity and payer policy—not the code category alone.