Oregon Administrative Rules
Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS
Division 140 - VISUAL SERVICES
Section 410-140-0300 - Post-operative Care
Universal Citation: OR Admin Rules 410-140-0300
Current through Register Vol. 63, No. 9, September 1, 2024
(1) The Division reimburses all covered surgical procedures as global packages, except when the surgeon codes the surgical procedure with a modifier indicating surgical procedure only, excluding post-operative care.
(2) Post-operative care provided outside the global package is:
(a) Reimbursable to
optometrists when furnished within their scope of practice;
(b) Billed with:
(A) The surgical CPT code billed by the
surgeon;
(B) The appropriate
modifier noting post-operative care only; and
(C) The first post-operative date of service;
and
(c) Reimbursed a
percentage of the global reimbursement.
(3) Post-operative care includes all related follow-up visits and examinations provided within:
(a) Ninety days following the date of major
surgery; or
(b) Ten days following
the date of minor surgery; and
(c)
Claims for evaluation and management services and ophthalmological examinations
billed within the follow-up period shall be denied.
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS 414.025 & 414.065
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