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CMS issues guidance to ASCs wishing to bill patients for P-C IOLs

Ambulatory Surgery Reimbursement Update, August 23, 2005

The Centers for Medicare & Medicaid Services (CMS) issued a transmittal offering guidance for ambulatory surgery centers (ASCs) who provide presbyopia-correcting intraocular lenses (P-C IOLs) and want to bill patients for the additional costs of the lens.

In May 2005, Medicare issued a ruling that allowed Medicare beneficiaries to offer the more expensive P-C IOL to be used in place of a standard intraocular lens following cataract surgery.

The guidance includes information on what lenses CMS recognizes as P-C IOLs, coding information, and some billing instructions. The guidance does not address the question of an upper limit on how much an ASC can charge a beneficiary for this, according to the Federal Ambulatory Surgery Association (FASA).

To read the alert FASA sent to its members regarding the transmittal, click here.

To read an article from CMS about P-C IOLs guidance, click here.

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