BUSINESS

  TECHNOLOGY

DECODE YOUR PATIENTS

PROVIDE GENETIC TESTING OPTIONS REGARDING BLINDING DISEASE

KEVIN GEE, O.D.

ON A daily basis almost every one of my patients asks me about their risk for AMD and glaucoma, probably because of the recent attention paid to these eye diseases via public service announcements and awareness campaigns. Genetic testing is one tool we can use to inform patients of their risk for these blinding eye diseases.

HOW THEY WORK

The companies that make genetic tests for AMD and glaucoma typically send their own testing kits to doctors. Such kits can include forms for both the doctor and patient and the materials required for DNA collection.

The sample (a cheek swab or blood test) is then mailed to the company’s lab for analysis, and the results are sent via snail mail and fax to you, the patient’s doctor.

With results in hand, you can then make the patient aware of his or her risk of developing AMD and/or glaucoma and determine what is needed, such as additional testing, nutritional supplements and/or close monitoring.

CODING REQUIREMENTS

Coding is easy for these two areas of genetic testing. Why? Because there is nothing to code, as the physician is only collecting a sample and not actually performing the clinical lab testing itself. In contrast, there are other point-of-care tests, that you can code for the test if your office has a clinical lab designation by CMS and a physician in the office is designated as the clinical lab director, but not in the case of AMD or glaucoma.

In fact, both point-of-care tests for AMD and glaucoma are not billable tests at all by the O.D. Why? Because the lab test itself is performed by an outside lab, and the OD is only collecting the clinical sample by method of a buccal (cheek) swab. That, in and of itself, is not a distinct and separate procedure, according to the CPT and, therefore, is part of the existing office visit.

Of course, once a diagnosis has been confirmed, then the additional special ophthalmic tests that may be medically necessary to perform based upon the individual patient’s clinical findings can then be ordered and performed in accordance with the local standards of care and carrier requirements. OM

DR. GEE practices in Houston and is an assistant clinical professor at the University of Houston College of Optometry. He is a Fellow of the American Academy of Optometry, an ABO Diplomate and an OCRT member. Also, he’s on Allergan’s advisory board and is a consultant for Solution Reach. Email him at drgee@geeeyecare.com, or visit tinyurl.com/comment to comment.