MAR 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/276058

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Page 153 of 210

E W MEETING REPORTER March 2014 1 51 Preparing for ICD-10 E. Ann Rose, president of Rose & Associates, Duncanville, Texas, spoke about ICD-10 and preparing for implementation. The go-live date is set for October 1, 2014, and this date is firm and not expected to change, based on CMS guidelines. Any provider covered by HIPAA must convert, with only a few ex- ceptions. These include providers other than Medicare and Medicaid, with the exception of workers' com- pensation, auto insurance, home owners' insurance, and business owner liability. In order to prepare for ICD-10, Ms. Rose said there are several things that should be done now. She said that each practice needs to identify how it will be affected by ICD-10. Creating a time- line chart and setting deadlines for completion; implementing strategies to address areas that are weak or lacking; and reviewing policies or procedures involving a diagnosis code, disease management, tracking or appeals process are other steps to take. Additionally, she said to make a checklist of everything you need to do to prepare for ICD-10. This checklist should include developing a project plan, getting other staff involved, estimating a secure budget for a number of issues that could arise, reaching out to your software vendor, touching base with your clearinghouse, talking to commer- cial payers about their testing op- tions, ordering new CMS-1500 claim forms, upgrading computer systems to handle new claim forms, updat- ing superbills and encounter forms, improving chart documentation, setting aside cash reserves, establish- ing a bigger line of credit at the bank, setting aside a three-month reserve to allow for any problems to get corrected, scheduling ICD-10 training, preparing for contingen- cies, and identifying solutions. Ms. Rose said that the AHIMA recom- mends that ICD-10 training be done six months before the compliance deadline. Finally, she highlighted some key information about imple- mentation and emphasized the importance of anticipating problems and resistance to change that could come with the implementation. Editors' note: Ms. Rose has no financial interests related to her presentation. Winter Update attendees got together for a Welcome & Networking Reception on Thursday night. Saturday, Feb. 15 The ASCRS•ASOA Winter Update opened Saturday with a "What's New in Technology" session, which was moderated by Roger F. Steinert, MD, Irvine Calif. Other faculty in the session included Garry P. Condon, MD, Pittsburgh, Brendan J. Moriarty, MD, Cheshire, U.K., Robert H. Osher, MD, Blue Ash, Ohio, Jonathan B. Rubenstein, MD, Chicago, Thomas W. Samuelson, MD, Minneapolis, and Kerry D. Solomon, MD, Mt. Pleasant, S.C. Dr. Rubenstein dis- cussed what's new in endothelial keratoplasty (EK). He mentioned the causes for a compromised endothe- lium in cataract patients, which in- clude Fuchs' dystrophy, advanced age, history of angle closure, history of trauma, chronic inflammation, and previous anterior segment surgery. "Fuchs' is the major one we deal with," he said. EK falls into several different categories, such as penetrating keratoplasty (PK), deep lamellar endothelial keratoplasty (DLEK), Descemet's stripping endothelial keratoplasty (DSEK), Descemet's membrane automated endothelial keratoplasty (DMAEK), and Descemet's mem- brane endothelial keratoplasty (DMEK). DLEK is not done as much anymore, he said. DSEK is a thinner form of EK, and DMEK is the proce- dure that many surgeons are moving toward now. "DSEK is still the most widely done of all the procedures of endothelial keratoplasty," Dr. Rubenstein said. "The biggest news in DSEK is the advances in insert- ers." These include the Neusidl Corneal Inserter (Fischer Surgical, Imperial, Mo.), the Tan EndoGlide (Angiotech, Vancouver), the Busin Glide (Moria, Doylestown, Pa.), and the EndoSerter (Ocular Systems, Winston-Salem, N.C.). Another development in DSEK is moving toward ultra-thin DSEK. There is a debate in the cornea community about whether ultra-thin DSEK or DMEK is better. Ultra-thin DSEK uses the same technique as DSEK but with thinner graft tissue, he said. The ultra-thin procedure uses grafts of 80–100 microns and it has a possibly higher rate of 20/20 VA compared to DSEK. Visual results for ultra-thin DSEK are similar to what's proposed for DMEK. "The advantage of this over DMEK is a lower rate of continued on page 152 149-159 MR WU2014_EW March 2014-DL2_Layout 1 3/6/14 4:21 PM Page 151

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