Practical Pearls

A Handy Guide to the Best Take-Home Tips in the October 2011 Issue of

A recent study reported no difference in central or peripheral PCO formation with the use of single-piece hydrophobic acrylic IOLs compared to three-piece lenses ……………………………Find it!

Registry reporting for PQRS filing shows an 88% success rate—significantly higher than that of office-based claims……………………………Find it!

A doctor does not have to be present at the UBM exam to bill for code 76513, but must order the test and provide an interpretation and report to receive full reimbursement…………………Find it!

A well-functioning ocular surface is the common denominator to achieving the best visual outcomes. Prioritize ocular surface health before moving onto other necessary remedies…Find it!

The ability to do more cases in a highly efficient ASC may be important to a hospital-employed ophthalmologist whose compensation is based on a “salary/plus” formula that encompasses productivity ………………………………………Find it!

Using an integrated EHR, practice and Web data-management system can be beneficial come troubleshooting time, since there is only one vendor to call…………………………………………Find it!

Proponents of data registries claim that they help physicians earn PQRS payments and also dramatically improve outcomes by providing physicians a “dashboard” to gauge the efficacy of their treatments……………………………………….Find it!

To duck the penalty for non-participation in e-Prescribing next year, physicians who do not qualify for an exception or apply for an exemption had to report 10 out of the total required 25 times from their offices (rather than through a registry) between Jan. 1 and June 30. After that, the submission of another 15 for a total of 25 is required in order to avoid the penalty in 2013 ……Find it!

As the trend toward performing routine outpatient ophthalmic procedures in standalone ambulatory surgery centers has picked up, there is ample evidence that hospitals have come to recognize that the ASC is a superior model for outpatient ophthalmic procedures………………………Find it!

The main advantages of offsite APC are a stable, specialized staff and less downtime between cases ………………………………………………Find it!

When coding for glaucoma, it is important to identify the severity or stage of the condition. These are supplemental codes reported along with the basic glaucoma code…………….Find it!

Checklists are an efficient and cost-effective mechanism for ordering and restocking expensive medical supplies where excessive inventory can decrease profitability and worse, lose you money due to unreturnable expired medications and sterile, single-use items ………………Find it!

Form an EMR committee that includes key members from different departments including billing, clinical, and administrative. Also involve an IT specialist early in the process, even if it means hiring someone from the outside. Just make sure it's someone with medical IT experience, not your nephew the tech geek……………………….Find it!

In IFIS patients, iris retractors and other expansion devices can help enlarge the pupil……….Find it!

“Low risk” for the open-angle patient is defined as having one or two risk factors, and “high risk” as having three or more risk factors. Risk factors include family history, race, elevated IOP, optic disc appearance and thin central corneal thickness ……………………………………………….Find it!

Allow for a gradual EMR rollout so that the clinic and billing office can work out the kinks. Converting all patients to EMR overnight is ill advised unless in a very small practice…Find it!

Reinvest any potential payroll tax-break savings into systems to lower your overhead and increase practice efficiency ……………………………Find it!

When managing patients on hydroxychloroquine, if changes like relative scotomas are found early and the drug is discontinued, disease rarely advances…………………………………………Find it!

The combination of oar-locking and decreased irrigation/aspiration throughput of smaller MICS instrumentation could cause cortical clean-up to suffer as incisions shrink ……………………Find it!

Get the EMR vendor to project the cost of ongoing IT expenses—given the size of your organization and the scope of the implementation. Ongoing IT support costs have been more than anticipated and it helps to have had this information from the beginning …………………………………………Find it!

To determine if the angle is open or closed in a glaucoma patient via UBM, it is imperative to identify the location of the scleral spur. Perform this examination with the room lights off to maximally crowd the angle………………………Find it!

Checklists are essential for safety, consistency and efficiency, and mandated by federal law in every hospital OR and ASC…………………Find it!

If considering the purchase of a femto laser for cataract surgery, be mindful of improvements to your practice facilities that may be needed to accommodate the equipment………………Find it!

The changes to the ICD-9-CM offer an enhanced ability to conduct health policy research. The new codes will allow claims-based information to better understand the patient populations…Find it!

Although collagen crosslinking is currently a time consuming procedure, most steps can be performed by a technician to keep up the physician's surgical flow ……………………………………Find it!

When explaining different lens options to your cataract patients, avoid making one lens sound “better” than another. Instead, be honest about the differences in each IOL and map out what each one has to offer …………………………Find it!

Be aware of your cataract patients' needs and outcome expectations. Addressing their biggest concerns can better ensure satisfaction. Try using the Dell Survey to find out what is most important to your patient………………………………….Find it!

For practices that already own an excimer laser, incorporating collagen crosslinking requires relatively few new tools or skill sets …………Find it!

Patients who have previously suffered NAION in one eye or who experience transitory visual loss on phosphodiesterase type 5 inhibitors should not take those drugs, to prevent NAION in the same or fellow eye if sildenafil is ingested…………Find it!

Using the ClearScan cover for ultrasound biomicroscopy devices has been shown to be safer, more comfortable and less traumatic than the open-shell and gel technique ………………Find it!

Riboflavin solution use for collagen crosslinking should be stored in vials not penetrated by light to maintain efficacy………………………………Find it!