Master The Skills Of Dry Eye Testing And Thrive

By Kate Gettinger, OD June 01, 2021

In these competitive times when independent practices are often vying against huge corporate box stores with seemingly unlimited budgets and resources, every small step you can make to set yourself apart can be absolutely worth the effort. Insurance payouts are shifting, and it no longer seems to be enough to simply deliver an excellent comprehensive eye examination. If you want to be able to keep doors open and the lights on, you’ll need to learn to be versatile. More and more patients are requiring medical interventions. It can be advantageous to change your office dynamic to split services evenly between routine vision and medical eye care in order to have the best reach. Practices that are leaning more into the medical side of eyecare are finding themselves in a league of their own and setting themselves safely on a different tier than the corporate chains.

A great starting point for practices looking to embrace medical services is dry eye. Dry eye is one of the most prevalent conditions among adults, and if you think your practice doesn’t have a lot of dry eye patients you may simply not be recognizing the signs or asking patients the right questions. Dry eye treatment not only gives you an opportunity to establish a steady stream of revenue, but also allows you to positively influence patients’ lives by providing symptom relief and protecting their eyes.

If you are skeptical about the impact of dry eye testing, start providing patients with a dry eye questionnaire as part of the standard intake procedure. Some popular dry eye questionnaires include the OSDI (Ocular Surface Disease Index), DEQ-5, and the SPEED (Standard Patient Evaluation of Eye Dryness.) Once you start asking these questions to patients, you may find that your practice has a significant amount of undiagnosed dry eye. These surveys can help you identify patients that could benefit from dry eye testing. If a patient gives a positive symptom response on the survey or shows signs of dryness in the exam chair, it indicates that further dry eye testing is warranted.

For dry eye patients, most optometrists agree that it is good practice to test tear film osmolarity as well as for inflammatory markers. One of the easiest ways to test for inflammatory markers in the tear film is by using an immunoassay like InflammaDry. InflammaDry is easy to set up in-office and requires no special training to utilize. It measures elevated levels of MMP-protein within the tears, which indicates inflammation. The procedure itself consists of single-use, disposable test that can be performed in-office by a technician within a matter of minutes and give a result within ten minutes.

InflammaDry can be billed under the CPT code of 83516, and the 2017 CMS national payment on this code is $15.82. Keep in mind that in order to be reimbursed, your office will need to have a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver. This means your practice has to have a clinical lab designation and at least one physician within the practice will need to be registered as a clinical lab director.

While this may seem like a lot of hassle for a small payout, it’s critical to keep in mind the big picture. If you have it established as a standard of care within your practice to perform an InflammaDry test on any patient indicated by dry eye questionnaire responses or clinical signs, you’ll find that the small amounts will add up quickly.

Consider how in this day and age of COVID, many patients are becoming increasingly symptomatic of dry eye due to increased screen times and mask use. Our reliance upon technology and the use of personal protective equipment isn’t going away anytime soon, and so we are likely to continue to see an uptick in dry eye patients. According to some estimates, a typical practice can expect to generate approximately $75 of revenue for every dry-eye-related office visit, while a punctal occlusion patient may bring in closer to $450. Don’t forget: these patients often need to come in several times a year to monitor the condition. In addition, these patients require osmolarity and inflammation testing, and some may elect for additional procedures such as Lipiflow or iLux. In the end, a dry eye patient has the potential to provide a significant source of revenue in your office.

A successfully treated dry eye patient is also much more likely to sing your praises and bring in additional patients. Someone may be satisfied with a basic comprehensive eye exam, but usually, it’s nothing worth bragging to friends about. However, if you manage to bring relief to someone who has been consistently struggling to find comfort and focus, you completely change their quality of life. These patients may be more willing to discuss their improvements with friends and family, which can lead to more word-of-mouth referrals. 

Being able to embrace the medical aspect of optometry and bring dry eye testing into the office benefits not only you but the patients you serve. With simple, slight adjustments to your patient intake and initiating new point-of-care testing, you can start seeing a positive change in both practice revenue and patient satisfaction. Dry eye testing is truly a win-win.

Kate Gettinger, OD

Dr. Kate Gettinger grew up in upstate Illinois and obtained her Bachelor’s in Biology from Truman State University. She worked throughout her undergraduate career at an optometrist’s office and fell in love with the profession. She received her Doctorate in Optometry from University of Missouri-St. Louis Optometry School and received honors for specialization in low vision, including the William Feinbloom Low Vision Award. Dr. Gettinger enjoys treating and managing dry eye, macular degeneration, glaucoma, and diabetes. Her professional interests include ways to improve healthcare access to at-risk communities and improving public health. Dr. Gettinger routinely contributes to optometry publications and writes both educational and advocacy articles. Currently residing in St. Louis, Dr. Gettinger enjoys spending time outdoors with her dog, trying new foods and dining out at local restaurants, playing trivia, brushing up on her French language skills, and exploring new challenges.

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