Full-Fee Reimbursement Under Medicare Advantage
Medicare makes separate payments for the acquisition of corneal tissue for use in corneal transplant and glaucoma shunt procedures. However, there has been some confusion about this policy, which has led to instances in which the tissue was billed incorrectly, and thus not reimbursed by Medicare.
These resources were developed by EBAA and AAO to help you secure the reimbursement to which you are entitled by CMS.
Resources include:
- Coding and Reimbursement Brochure (pdf format)
- Coding and Reimbursement Brochure (for printing)
- Eye Bank Sample Invoice
- Reimbursement Talking Points
- Sample Verification Letter for Physicians
- Sample Appeals Letter for Physicians
- HCPS Listing for Code V2785
- CMS Claim Processing Manual
Corneal Tissue Reimbursement Video Series
EBAA partnered with the AAO’s reimbursement experts to develop a three-part series that provides tools and strategies for submitting clean claims, negotiating strong contracts, and preventing claim denials. Heather Dunn, AAO’s Coding and Reimbursement Manager, offers in-depth knowledge about ocular tissue reimbursement and offers insight into receiving reimbursement for the tissue provided for transplant.
Videos:
- Back to Basics: Submitting Clean Claims
- Contracting Considerations
- Preventing and Resolving Claim Denials
