Hydrus Microstent Removal and Repositioning

I. Paul Singh, MD

Eyetube

I. Paul Singh, MD, shares a case of a highly myopic patient in which a previously implanted Hydrus Microstent (Alcon) was not correctly positioned. This video shows how to efficiently and safely grasp and remove the device and place it in a different location. Financial Disclosure: Consultant (Alcon)

Prioritizing Ocular Wellness and Hygiene

Joseph J. Allen, OD, FAAO, Dipl ABO

Eyetube

Joseph J. Allen, OD, FAAO, Dipl ABO, describes a trend in eye care that models routine exams after those that take place in dentistry (ie, beginning the eye exam with an ocular surface cleansing procedure, then educating patients on everyday ocular wellness and hygiene practices, before performing the actual eye exam). Dr. Allen also shares ideas for incorporating such cleansing procedures into your own practice offerings.

How to Implement the –JZ Modifier

Reporting zero waste when administering therapeutics is going to look a little different this year. Here’s why.

Joy Woodke, COE, OCS, OCSR

Retina Today

Reporting drug usage and waste in the retina clinic has always been trickier than you would expect. Given the sheer volume of therapeutics used to treat everything from diabetic eye disease to AMD—and now geographic atrophy—it’s a crucial coding skill to have. Since 2017, to obtain full reimbursement for single-dose containers, vials, and packages for both the injected and discarded amounts of a drug, 1 unit or greater, physicians have reported the –JW modifier, discarded drug not administered. The Centers for Medicare and Medicaid (CMS) have monitored the use of the –JW modifier and, because of noncompliance, have reported incomplete data on drug wastage. As a result, the CMS created a new modifier, –JZ, zero drug amount discarded/not administered to any patient, that went into effect January 1, 2023.1 Collectively, the claims data from the –JW and –JZ modifiers will be used to calculate discarded drug refunds for manufacturer rebate requirements. Physicians shouldn’t be too surprised, considering CMS announced this change in their Final Rule in November 2022.1 The –JZ modifier was effective starting January 1, 2023, but the required use of the –JZ modifier was set for July 1, 2023. This new modifier will be appended to the Healthcare Common Procedure Coding System (HCPCS) code representing the drug used. If not reported when applicable, claims could be subject to audits, and if not used by October 1, 2023, claims may be returned as unable to process. The –JW and –JZ modifiers are required for single-dose containers, vials, and packages based on the FDA-approved labeling. It is important to confirm if the drug is considered a single dose by reviewing the vial or package labeling.