Practical Pearls

A Handy Guide to the Best Take-Home Tips in the February 2010 Issue of Ophthalmology MANAGEMENT

CMS has recently eliminated consultation codes. Visits previously coded as outpatient consults must be coded with E/M codes (992XX) or eye codes (920XX)………Find it!

Poor vision due to insufficient postop steroid use may be the “hidden culprit” in cases of patient dissatisfaction with premium IOLs………Find it!

In patients who have undergone collagen cross-linking, the increased rigidity of the cornea may influence tonometry readings and thus overestimate IOP………Find it!

Despite the federal mandate to adopt EMR, over one-third of opthalmologists in a recent survey have no plans to do so………Find it!

Next to your optometrists, the optician is the second most important professional your practice will employ………Find it!

You can reduce your electric bill 10% by installing large windows/skylights that allow natural sunlight to replace electric lighting and motion sensors that shut off lights in unused rooms………Find it!

Most residents have exposure to some trabeculectomy surgery and an occasional shunt. Few leave training having completed large numbers of any surgical glaucoma procedure………Find it!

When gauging whether a patient is a good candidate for premium IOLs, seek the impressions of your staff. Patients are eager to please the doctor and may overestimate to you their willingness to tolerate imperfect results; with staff, however, they'll be more forthcoming………Find it!

Committing the clinical staff to a select group of products gives the practice greater purchasing power while also standardizing some aspects of the care provided………Find it!

The ExPress Mini-Shunt may serve as a bridge procedure for general ophthalmologists interested in glaucoma surgery but not ready for the complexity of complications that occur with tube shunt implanation………Find it!

In 2010, doctors can earn a 2% bonus on their Medicare charges by using e-prescribing at least 25 times. However, in 2011 the requirement jumps to 80% of all prescriptions written for Medicare patients………Find it!

Corneal hysteresis, a direct measure of the cornea's biomechanical properties, may more completely describe the contribution of corneal resistance to IOP measurements than central corneal thickness alone………Find it!

Lighting is one of the easiest and cheapest ways to begin greening your practice. In addition to compact fluorescent lights, LEDs are another energy-saving option and may be more efficient than fluorescent bulbs………Find it!

Ophthalmologists' top concern when selecting an EMR vendor is its reputation and track record in serving ophthalmology………Find it!

Surgeons taking a DSEK course should expect to stay for one to two days. Courses usually entail a wet lab, observing live surgery, examining postops and problem-solving………Find it!

Minimal visual loss in the presence of ocular disease seems to reduce quality of life to the same degree as having diabetes mellitus or a mild stroke………Find it!

According to some cataract surgeons, instrument manufacturers are now offering some excellent disposable alternatives to diamond blades, thanks to improved steel technology and new blade materials………Find it!

Cataract surgeons looking to add premium IOLs to their practice need to accept and account for retreatments — in terms of pricing, scheduling and patient education………Find it!

Although patients with functional vision can usually perform the typical activities of daily living, the anxiety caused by the potential for further visual loss is reflected in their decreased overall quality of life………Find it!

The 30% of revenues that an optical dispensary can generate for an ophthalmology practice is a buffer against cuts in Medicare reimbursements and managed care payments………Find it!

The skill set needed and learning curve of the Trabectome procedure make it an ideal procedure for both general ophthalmologists and glaucoma specialists………Find it!

Doctors who worry about EMR's drain on productivity tend to focus on the data intake phase of the process. That decline can be offset by time saved in scheduling follow-ups, billing, prescriptions and other post-exam tasks………Find it!

Office policies about clinical care should include some flexibility when possible. Otherwise, individual doctors may feel straight-jacketed if every thing must be done “by the book.”………Find it!

DSEK training is offered in southwest Florida, Indianapolis and Oregon, giving interested surgeons the opportunity to take a course without having to travel a great distance”………Find it!

European surgeons have embraced single-use instruments because of the urgency of mad cow/Creutzfeldt-Jakob disease. Some European countries, in fact, mandate use of a disposable option when available………Find it!

Because many general ophthalmologists have done only a few glaucoma tube shunts in their training, they often have to take skills-transfer courses and wet labs at the AAO annual meetings to gain proficiency………Find it!

The biggest impediment to wider EMR adoption is cost — both the initial outlay and the monthly maintenance………Find it!

Knowing how much you currently spend on energy bills can make a green makeover, with its higher upfront costs, less daunting, and at least provide a baseline measurement. Measure energy utilization per square foot every month and track its progress over time………Find it!

Periodically reviewing the clinical practices of each doctor on staff for compliance with preset standards and policies can identify lapses in care that must be addressed………Find it!