Compliance plan written specifically for eyecare is the result of
well over forty hours of consulting time. Click
here to review a DRAFT copy of the plan.
The Key to a Coding Compliance Plan
is consistency. This Coding Compliance Plan for
Ophthalmology/Optometry establishes standards for formats and
It is recommended the practice
performs between 3 to 30 audits per provider. Determine if audits
are quarterly, bi-annual or annual. Be sure to document
benchmarks, clearly define how to fix any problems and provide and
document training for the Providers.
The final and most important
component is a follow-up audit in 3, 6 or 12 months and compare
and evaluate progress. Sometimes it is best to get an outside or
third-party to conduct the coding audit.
It includes the seven (7) elements
of an OIG compliance Plan:
- Conducting compliance &
- Implementing compliance and
- Designating a compliance officer
- Conducting appropriate training
- Responding appropriately to
detected offenses and developing corrective action.
- Developing open lines of
- Enforcing disciplinary standards
through well-publicized guidelines.
The Coding Compliance Plan for
- Lists of ICD-9 codes that can
cause problems (fifth digit accuracy and required second
- Lists of specific CPT codes to
- An Evaluation and Management
- An Eye Exam (920xx) Audit Form.
- Specific eyecare audit elements