Specialized Testing Intro

Question 1

Is specialty testing used to make or confirm diagnosis?

Answer 1

Confirm

Question 2

What are the 3 C’s that must be included when analyzing tests?

Answer 2

Clinical diagnosis, comparative data, clinical management

Question 3

Every billed test needs its own ___________

Answer 3

Report

can’t lump photos and FA together in one report

Question 4

4 key aspects to analyzing tests

Answer 4

Reliability, interpretation, baseline vs comparison (must be same modality), plan

Reliability: make corrections and repeat if needed
Interpretation: wnl, abnormal, questionable and why with brief explanation of key data
Baseline vs comparison: must be same modality for accurate comparison
Plan: treatment and follow-up

Question 5

Components of Patient education

Answer 5

• Diagnosis with brief explantion
• Prognosis
• specilaty test explanation when relevant
• Treatment
• Follow-up

Question 6

What are the two parts that reimbursement is broken down into?

test components for billing

Answer 6

1. Technical: cost of equipment, maintenance, tech service
2. Professional: interpretation and report document

full reimbursement if both parts completed

Question 7

What tests can NOT be billed with fundus photos on the same visit?

Answer 7

• Fundus photo and OCT: bill the test that is most informative
• Fundus photo and FAF: use same code (99250)
• OCT nerve and retina

tests can be unbundled and billed with modifier -59 if truly justified

Question 8

Does fundus camera or Optos have a wider field?

Answer 8

Optos (210 degrees)

Question 9

What type of findings are better viewed on fundus camera?

Answer 9

Subtle posterior pole findings, optic nerve (glc)

Question 10

What are key features to highlight when interpreting fundus photo?

Answer 10

Media, disc (color, contour, sharpness), macula, vessels, periphery