New DMEPOS Specialty Code for Ocularists
August 27th, 2010
Effective Jan. 1, 2011, the Centers for Medicare & Medicaid Services (CMS) will establish durable medical equipment prosthesis, orthotics and supplies (DMEPOS) specialty code B5 for ocularists.
The American Society of Ocularists defines an ocularist as a “carefully trained technician skilled in the arts of fitting, shaping, and painting ocular prostheses.” In addition to creating ocular prostheses, the ocularist shows the patient how to handle and care for them, and provides long-term care through periodic examinations.
Patients who need to be referred to an ocularist usually fall into the following categories:
- Recent enucleation/evisceration
- Problems with an existing prosthesis
- Blind eyes requiring a scleral shell
- Congenital anophthalmia/microphthalmia
Patients with existing ocular prostheses often need to be referred to the ocularist for problems with either the surface condition of the prosthesis or problems with the fit of the prosthetic eye or scleral shell.
Services provided by the ocularist include:
- Cleaning
- Polishing
- Enlargement
- Reduction
- Replacement
Due to the requirements of most insurance policies, a written prescription from the referring physician or other appropriate eye care specialist often is required.
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