OMDI as an Alternative to Prostaglandin Analogues in Low or Nonresponders

Joseph F. Panarelli, MD; and Neda Shamie, MD

Eyetube

Joseph F. Panarelli, MD, sits down with Neda Shamie, MD, to discuss a phase 3, nonrandomized, two-phase, open-label, multicenter study that evaluated the IOP-lowering efficacy and safety of omidenepag isopropyl (OMDI) in patients with primary open-angle glaucoma or ocular hypertension who did not respond or responded poorly to latanoprost. What were the results? To access the full review, please visit the link here: https://pubmed.ncbi.nlm.nih.gov/37853676/

Autoimmune Disease and the Eye

Many affected patients will present with ocular signs and symptoms.

Anthony DeWilde, OD, FAAO

Modern Optometry

Autoimmune diseases are a complex set of conditions, in which the immune system mistakenly targets healthy cells instead of foreign cells. This can lead to significant morbidity and mortality. Autoimmune disease is the second highest cause of chronic illness in the United States. All in all, there are more than 80 types of autoimmune diseases.1 Diagnosing autoimmune diseases can be difficult, often due to lack of access to health care, testing options that are expensive and difficult to obtain, lack of specificity with testing modalities, and vague symptoms. From initial symptoms to final diagnosis, the process typically takes an average of 4.5 years and involves up to four doctors.2 ODs are in a unique position to help patients with autoimmune disease, as many of these conditions manifest with ocular signs and symptoms. By understanding the association between autoimmune disease and the eye, we can detect early signs and symptoms, allowing earlier referral and treatment. The number of autoimmune diseases that can affect the eye is vast. As such, this article will focus on the three main conditions that I’ve encountered over the course of my career: myasthenia gravis (MG), thyroid eye disease (TED), and giant cell arteritis (GCA). MYASTHENIA GRAVIS MG is a chronic autoimmune disease where autoantibodies bind to the neuromuscular junction, blocking its ability to receive normal signals from acetylcholine. This manifests as muscle weakness and fatigue.

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.