Perspective

Claims review highlights medical diagnoses found in vision exams

Carl Moroff
Carl Moroff

Vision care programs bring employers the potential added benefits of early diagnosis of systemic conditions and reduction of overall health care costs, according to executives at National Vision Administrators.

NVA administers vision and eye care services to more than 7.5 million lives in all 50 states. Carl Moroff, OD, chief medical officer, and Barnet Shuman, OD, MPH, optometric consultant, analyzed a sample of the ICD-10 diagnosis codes received in 2017 as part of routine vision care program claims processing with the goal of demonstrating the wide range of medical conditions and diagnoses vision care providers encounter during routine office visits.

Moroff and Shuman told Primary Care Optometry News that of the 1,583,080 sample diagnoses reviewed in this patient population, 1,463,516 indicated diseases of the eye and adnexa, 1,085,405 were for refractive errors, 378,111 were for other eye diagnoses, and 11,246 were for non-ocular systemic diagnoses.

Some of the major systemic conditions reported as part of these routine vision care visits included: hyperglycemia/diabetes (3,285), hypertension (995) and hyperlipidemia (153).

Barnet Shuman
Barnet Shuman

“Doctors may not report all systemic disease conditions on a vision care claim, so it is most likely that these diagnoses are significantly underreported in these claims,” the doctors told PCON. “However, when the reporting of such diagnoses occurs, it infers that the doctor is aware of the systemic conditions and is monitoring the patient for any manifestations or problems from these conditions.”

Moroff and Shuman said that many employees and employers do not understand the connection between eye and overall health and how routine vision exams can identify systemic conditions.

“Many individuals go years with no medical interaction other than visiting their eye doctor,” they said. “These data show that routine vision exams are anything but routine.” – Nancy Hemphill, ELS, FAAO

For more information:

Moroff can be reached at cmoroff@e-nva.com. Shuman can be reached at bshuman_cntr@e-nva.com.

Disclosures: Moroff is employed by NVA. Shuman is an optometric consultant to NVA.

 

 

Carl Moroff
Carl Moroff

Vision care programs bring employers the potential added benefits of early diagnosis of systemic conditions and reduction of overall health care costs, according to executives at National Vision Administrators.

NVA administers vision and eye care services to more than 7.5 million lives in all 50 states. Carl Moroff, OD, chief medical officer, and Barnet Shuman, OD, MPH, optometric consultant, analyzed a sample of the ICD-10 diagnosis codes received in 2017 as part of routine vision care program claims processing with the goal of demonstrating the wide range of medical conditions and diagnoses vision care providers encounter during routine office visits.

Moroff and Shuman told Primary Care Optometry News that of the 1,583,080 sample diagnoses reviewed in this patient population, 1,463,516 indicated diseases of the eye and adnexa, 1,085,405 were for refractive errors, 378,111 were for other eye diagnoses, and 11,246 were for non-ocular systemic diagnoses.

Some of the major systemic conditions reported as part of these routine vision care visits included: hyperglycemia/diabetes (3,285), hypertension (995) and hyperlipidemia (153).

Barnet Shuman
Barnet Shuman

“Doctors may not report all systemic disease conditions on a vision care claim, so it is most likely that these diagnoses are significantly underreported in these claims,” the doctors told PCON. “However, when the reporting of such diagnoses occurs, it infers that the doctor is aware of the systemic conditions and is monitoring the patient for any manifestations or problems from these conditions.”

Moroff and Shuman said that many employees and employers do not understand the connection between eye and overall health and how routine vision exams can identify systemic conditions.

“Many individuals go years with no medical interaction other than visiting their eye doctor,” they said. “These data show that routine vision exams are anything but routine.” – Nancy Hemphill, ELS, FAAO

For more information:

Moroff can be reached at cmoroff@e-nva.com. Shuman can be reached at bshuman_cntr@e-nva.com.

Disclosures: Moroff is employed by NVA. Shuman is an optometric consultant to NVA.

 

 

    Perspective
    Scott A. Edmonds

    Scott A. Edmonds

    This important review of claims for routine vision exams demonstrates a major point for the American health care crisis. Optometrists interface with patients with systemic medical problems or those at risk to develop these problems. The modern training of an optometrist that includes a medical curriculum such that each graduate can prescribe medicines to treat pathology requires a broad understanding of systemic disease. Diabetes, hypertension and dyslipidemia can affect the eye and visual system and must be evaluated as part of a comprehensive eye exam.

    As this landmark work notes, this is happening in routine vision care without any effort to promote the primary health care role of the optometrist. Health plans that identify, quantify and manage the role of the optometrist in primary care and the comanagement of chronic systemic health problems will be able to improve overall health outcomes for their members.

    • Scott A. Edmonds, OD, FAAO
    • Chief medical officer, March Vision Care, Co-director, Low Vision/Contact Lens Service, Wills Eye Institute, Philadelphia, PCON Editorial Board Member

    Disclosures: Edmonds is a consultant for March Vision and OcuHub.