A Message from Your President

Dr. Lori Gray (POA Secretary-Treasurer) attended the Chester-Delaware Optometric Society meeting with me a couple weeks ago. We had some great CE on diabetes and nutrition, and a very informative business meeting. I was very excited to see the comradery among the members, with lots of idea sharing, practice management tips and clinical discussions before and after the meeting. Some doctors spend a lot of money hiring consultants to help them with their practice, but if you aren't also taking advantage of the great resources you have in your local colleagues, you are really missing out on one of the greatest benefits of your POA membership.

From left to right: Dr. Ryan Edmonds (CDOS President), Dr. Richard Christoph (POA President), and Dr. Lori Gray (POA Secretary-Treasurer)

The 21st Century Eye: Protecting Your Vision Three Ways

Pennsylvania Optometric Association provides tips for Save Your Vision Month

Everywhere we go, we're reading, shopping, banking, or being entertained online via digital devices small and large - at work, school, vacation, and on our way in-between. In fact, according to the American Optometric Association's (AOA) 2014 American Eye-Q® survey, 55 percent of adults are using computers, smartphones, tablets and other hand-held devices for at least five hours a day. A separate AOA survey showed that 83 percent of children, ages ranging from 10-17, use an electronic device for more than three hours a day. Digital use will only continue to increase, making it important for consumers to make smart eye care choices like seeing an eye doctor for yearly comprehensive eye exams.

Below are three tips from the Pennsylvania Optometric Association (POA) in observance of Save Your Vision Month, which occurs yearly in March.

Give Your Eyes a Break

The POA recommends following the 20-20-20 rule to discourage digital eye strain - take a 20-second break every 20 minutes to view something 20 feet away.

Regular, lengthy use of technology may lead to digital eye strain, which is a temporary condition, but one that includes symptoms like burning or tired eyes, headaches, fatigue, loss of focus, blurred or double vision, or head and neck pain.

Early research has also shown that overexposure to high-energy, short-wavelength blue and violet light emitted from electronic devices may also contribute to digital eye strain. This blue light also increases the likelihood of developing serious eye conditions such as age-related macular degeneration. Optometrists offer lens options including non-glare, filtering lenses, to help protect vision from harmful blue light.

Be a Savvy Shopper

There are many products available for purchase online, but prescription eyeglasses should not be one of them. Eyeglasses are meant to be individually custom-made; health and safety should trump convenience when it comes to eyewear. Internet orders often result in incorrect prescriptions, not to mention all the other problems that occur with any online transaction that can cost consumers more money and a great deal of hassle. According to a 2011 study done by the AOA, the Optical Laboratories Association and The Vision Council, nearly half of all glasses ordered online had either prescription errors or failed to meet minimum safety standards.

Eyeglasses are a medical device and should be treated as such. They are an investment in your health and future, and must be custom-fitted not only for comfort, but also to be sure precise prescription needs are met so that the wearers are seeing his or her best.

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There is no substitute for a comprehensive, yearly eye exam by an eye doctor. Despite catchy claims, there is no "app for that." While a variety of new mobile applications and websites claim to evaluate vision or the fit of eyeglasses, often inaccurate or misleading information is given, and misinformed consumers end up delaying essential, sight-saving exams. Early diagnosis and treatment are critical in preventing a total loss of vision and often improve quality of life.

One of the most important, preventive ways to preserve vision and accurately assess eye health is to have yearly, comprehensive eye examinations. Diagnosing an eye disorder or disease, or determining if corrective lenses are needed, is also determined by these helpful eye examinations.

To find a nearby doctor of optometry, or for additional information on eye health in the 21^st century, please visit www.poaeyes.org.

About the Pennsylvania Optometric Association (POA):The Pennsylvania Optometric Association is the professional organization for over 1,250 doctors of optometry in Pennsylvania. An affiliate of the American Optometric Association, POA promotes the highest quality eye and vision care by optometrists, represents optometry to state government, provides its members with post-graduate education and membership benefits, and conducts activities in the interest of the visual welfare of the public. For more information, visit www.poaeyes.org.

About the American Eye-Q® survey:The ninth annual American Eye-Q® survey was created and commissioned in conjunction with Penn, Schoen & Berland Associates (PSB). From March 20-25, 2014, PSB conducted 1,000 online interviews among Americans 18 years and older who embodied a nationally representative sample of the U.S. general population. (Margin of error is plus or minus 3.10 percentage points at a 95% confidence level)

About the Children's Omnibus survey:The children's Omnibus survey was created and commissioned in conjunction with Penn, Schoen & Berland Associates (PSB). From March 24-31, 2014, PSB conducted 200 online interviews from March 24-31, 2014 with children ages 10 to 17. (Margin of error is plus or minus 6.93 percentage points at a 95% confidence level)

About the American Optometric Association (AOA):The American Optometric Association, a federation of state, student and armed forces optometric associations, was founded in 1898. Today, the AOA is proud to represent the profession of optometry, America's family eye doctors, who take a leading role in an individual's overall eye and vision care, health and well-being. Doctors of optometry (ODs) are the independent primary health care professionals for the eye and have extensive, ongoing training to examine, diagnose, treat and manage disorders, diseases and injuries that affect the eye and visual system, providing two-thirds of primary eye care in the U.S. For information on a variety of eye health and vision topics, and to find an optometrist near you, visit www.aoa.org.

PA optometrists now paid for additional procedure codes

In November of 2014, the POA sent a letter to the Department of Human Services requesting that optometrists get paid for ten Common Procedural Terminology (CPT) procedure codes. The POA is pleased to report that the department reviewed the optometrist’s Scope of Practice under the Pennsylvania State Board of Optometry and has determined that nine out of ten codes submitted for review will now be payable to optometrists.

For payment purposes, optometrists will be added to procedure codes 65778, 68761, 76510, 76511, 76512, 76516, 76519 and 92025, which already exist on the MA Program Fee Schedule. The department will issue a MA Bulletin to provide further payment information regarding these procedure codes to MA Program-enrolled optometrists. The department expects to issue the bulletin by the end of the first quarter of 2015.

The procedure code 83516, which was not added to the MA Program Fee Schedule, was left out because of the lack of specificity of the tested analyte. The department does not pay laboratories or physicians for this procedure code under the Fee-for-Service delivery system.

If the prescriber determines that the service reflected by procedure codes 65778, 68761, 76510, 76511, 76512, 76516, 76519 or 92025 is medically necessary, the prescriber may request a Program Exception through the 1150 Administrative Waiver Process, depending on the procedure specified in their MA Program Provider Handbook (Section 7.3), which is accessible by this URL: www.dhs.state.pa.us/cs/groups/webcontent/documents/form/s_001840.pdf.

Note: Optometrists rendering vision services under the managed care delivery system should address coding and payment questions to the appropriate managed care organization.

This is just another reminder of how the POA and its Third Party Center continually monitor payer issues and fights for you and your patients.

A Message from Your President

Thanks to the Lehigh Valley Optometric Association for its hospitality and for hosting a great meeting last night. As POA President, it is a great privilege to have the opportunity to attend local society meetings and talk with members. Congratulations and thanks to their Board of Directors as they start their new two-year terms of office.

From left to right: Dr. Mark Dalton (President), Dr. Serena Cox (Vice President), Dr. Carolyn Novak (Treasurer), Dr. Richard Christoph (POA President), and Dr. Steven Eiss (Board of Directors Trustee)

A Message from Your President

Last night in Wilkes-Barre, I had the honor of installing the Northeastern PA Optometric Society officers at their meeting. I thank these members for volunteering their time and talents to further our profession. Congratulations to the officers, and also to the society for having such a large group of dedicated leaders, which includes some energetic new members and some members of the seasoned old guard who will work well together. I appreciated the warm welcome and hospitality that was extended to me, and I look forward to attending more local society meetings throughout the state in the coming year.

Back row: Dr. Richard Christoph (POA President), and Dr. David Evans (Board of Directors Trustee)
Middle row: Dr. Ken Savitski (Trustee), Dr. James Deom (Vice President), and Dr. Tammy Warmouth (Trustee)
Front row: Dr. Ashley Wagner (Vice President), Dr. Donna McLaughlin (Treasurer), Dr. Sherry Winn (President), and Dr. Donna Buraczewski (Secretary)

News You Can Use from the Third Party Center

By Dr. Mark Margolies
POA President-Elect

It was recently brought to the attention of the POA’s Third Party Center (TPC) that an in-office diagnostic test, InflammaDry, was being reimbursed by Medicare when performed by ophthalmologists, but not optometrists in Pennsylvania. Through a combined effort with our TPC colleagues in New Jersey, led by Dr. Charlie Fitzpatrick, we were able to get Novitas to correct this situation and now optometrists in Pennsylvania, as well as ten other states, are able to bill and get paid for this diagnostic test by Medicare.
Novitas administers the Medicare contract in eleven states and Washington, D.C. These states are Pennsylvania, New Jersey, Maryland, Delaware, Colorado, Oklahoma, New Mexico, Texas, Arkansas, Louisiana and Mississippi.
According to Rapid Pathogen Screening, Inc., InflammaDry is the first and only rapid, in-office test that detects MMP-9, an inflammatory marker that is consistently elevated in the tears of patients with dry eye disease. Using direct sampling microfiltration technology, InflammaDry accurately identifies elevated levels of MMP-9 protein in tear fluid samples taken from the inside lining of the lower eyelid, the palpebral conjunctiva.
In order to be able to perform and bill this test to Medicare, the first step is to apply for a CLIA certificate from CMS. The objective of the CLIA program is to ensure quality laboratory testing. The InflammaDry test is one of several that is exempt from the CLIA program, and therefore the next step is to obtain a CLIA Waiver to perform this test in your office. The needed forms can be found on the CMS.gov website. Click here for helpful information.
The InflammaDry test is billed with CPT code 83516QW. The code 83516 has historically been aligned with complex lab tests not used by eye care professionals. The new CPT code coupled with the QW modifier indicates that a CLIA certificate of waiver is required when used by eye care professionals.
If you are interested in adding this service to your practice, please contact Rapid Pathogen Screening at info@rpsdetectors.com or by calling (877) 921-0080.

InfantSEE Success Story - Dr. Arnold Bierman

The following success story comes from Dr. Arnold Bierman.

A 10-month-old patient was brought to Dr. Bierman due to the child’s lateness in crawling, standing and walking. The patient’s mother told Dr. Bierman that there was a history of bad eyesight on the patient’s father’s side and she wanted to rule out visual problems that might be contributing to developmental delay.

Upon examination, Dr. Bierman discovered the patient was significantly farsighted in each eye, the right eye being +4.25 and the left eye +5.25 on objective near point retinoscopy. He informed the mother that glasses would be best for the child.

This is when obstacles presented themselves to Dr. Bierman and the patient. The child’s pediatrician requested a report of Dr. Bierman’s findings, and the child’s father did not want the baby to have glasses. While in contact with the pediatrician, Dr. Bierman found out that an appointment for the patient was already made to have him evaluated by a pediatric ophthalmologist despite his having been examined and diagnosed by Dr. Bierman.

Following that appointment, the chief pediatric ophthalmologist at Children’s Hospital of Philadelphia spoke with Dr. Bierman and told him that all his findings were valid and he agreed with Dr. Bierman’s desired course of action. The family followed through with Dr. Bierman’s original recommendations and ordered the glasses. Dr. Bierman contacted the patient’s mother to check in with the boy and the mother reported that “he’s like a different child” now.

Thanks for sharing your success story, Dr. Bierman! If you have an InfantSEE success story, send it to Kelsey@poaeyes.org to be included in a future issue!