Eye wear may be a fashion accessory, but when you depend on it for seeing the world, it’s a lot more. Today, many people are turning to refractive laser eye surgery, such as Lasik surgery, to improve their vision. However, this high-cost surgery is normally not paid for by insurance because it fails to meet the conservative therapy test and is classified as cosmetic. This trend is shifting.

We are seeing an increasing number of circumstances where refractive eye surgery is determined to be medically necessary and, therefore, payable by the insurance provider. For example, if conservative therapy treatments fail or if a patient is intolerant of contact lenses and cannot wear glasses because they might pose a risk in their job (e.g. police or firefighters), refractive eye surgery may be the most medically viable treatment option.

Conservative Therapy Options:

Examples of conservative therapy treatments include the following:

Photorefractive keratectomy (PRK) – a refractive laser surgical procedure that is often done (and covered) for a patient that suffers from recurrent corneal erosion (e.g. diabetics). With PRK, a laser is used to remove corneal tissue to correct vision problems.

Patching, epithelial debridement (mechanical removal of faulty tissue), and bandaged contact lens placement – treatments that often don’t work.

Stromal puncturing – a procedure involving the physician puncturing the anterior corneal stroma – can also be used but can fail or result in permanent vision loss. In such cases, PRK is the best alternative for removing the damaged cells (or membranes) and possibly correcting the vision problems.

Physicians can help patients who are in medical need of laser eye surgery make a stronger case by initiating the following:

Document a full medical history of the patient’s eye complaints

Show proof that the patient has not responded to conservative treatments and that the purpose of the surgery is for medical reasons other than simply improved eyesight

Still, even when the physician does this, each decision is taken on a case-by-case basis and is subject to the extenuating circumstances clearly noted in the patient’s medical record.

For more information about medical necessity reviews on cases like this, visit our website or call us at 1-800-400-9916.

About The Author

AllMed Healthcare Management Founded in 1995, AllMed (http://www.allmedmd.com, http://www.allmedmd.com/blog/index.htm) is a URAC-accredited Independent Review Organization (IRO) serving insurance payers, providers, TPAs and claims managers nationwide. Reviews are conducted by board-certified physicians in active practice. AllMed's growing customer base includes premier organizations, such as Educator's Mutual Life, IMS Managed Care, Tenet Healthcare Corporation, HealthGuard, several Blue Cross Blue Shield organizations, TriWest Healthcare Alliance, Allianz and many other leading healthcare payers.

info@allmedmd.com

A Quick Note From The Publisher... If you like the article above, you may be interested in the following article which is also related to Lasik... FDA Approves Lasik Eye Surgery The Food and Drug Administration (FDA) approved a new custom lasik procedure in September of 2005. This new procedure can now treat many patients who were previously ineligible for the surgery. Nearsightedness Nearsightedness occurs when the eye is too long and light rays focus in front of the retina, instead of focusing on the retina. Some of the symptoms of nearsightedness are blurred distant vision, eyestrain, and squinting, along with having a difficult time seeing at night. Although nearsightedness can be easily fixed with glasses or contact lenses (when not too severe), many people don't like to hassle with either one. With this new lasik procedure, folks will now be able to have pure vision. Astigmatism Astigmatism is the effect of the eye being shaped like a football, instead of round like a baseball. This deformity -- where the light rays focus on two points on the retina instead of one -- results in blurred vision, double vision, and...

Lasik, Lasik Eye Surgery News

Icon LASIK Announces Sunglass Trunk Shows at Its Cherry Creek Eye Care Center DENVER, CO-- - ICON LASIK announces several eye wear and sunglasses Trunk Shows in Denver during early 2012. The Trunk Shows feature major sunglass designers including Fendi sunglasses, Roberto Cavalli ... Avedro Announces Canadian Approval for Lasik Xtra™ Avedro, Inc. announced today that the Company’s proprietary Lasik Xtra procedure has received Canadian Approval. Lasik Xtra is a two minute procedure used in conjunction with standard Lasik to restore biomechanical integrity and strength to the cornea after a standard Lasik procedure. Free LASIK for Your Valentine, a Gift from Khanna Vision Institute If one does LASIK eye procedure with Dr. Khanna either in Beverly Hills or Westlake Village, their valentine will get a gift card for free LASIK of equal value, which can be used anytime, or can be donated to charity.Beverly Hills, California (PRWEB) February 08, 2012 Valentine's Day is a very important day to express love and appreciation for one’s beloved. Vision is equally important. ... Lasik surgery improves vision for almost everyone DEAR DOCTOR K: I’ve worn glasses and contact lenses for years. I just scheduled LASIK surgery. What will happen during this procedure?