OCS learner - Ophthalmic Coding Specialist Updated: 2023
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OCS Ophthalmic Coding Specialist
Test Detail:
The OCS (Ophthalmic Coding Specialist) test is conducted to certify individuals who possess the knowledge and skills required to accurately assign medical codes for ophthalmic procedures and services. The test evaluates the candidate's understanding of coding guidelines, reimbursement policies, and ophthalmic terminology.
Course Outline:
The course for the OCS certification covers various syllabus related to ophthalmic coding. The following is a general outline of the key areas covered:
1. Introduction to Ophthalmic Coding:
- Overview of the role of an Ophthalmic Coding Specialist.
- Understanding the purpose and importance of accurate medical coding.
- Familiarization with coding systems and guidelines specific to ophthalmology, such as CPT, ICD-10, and HCPCS.
2. Ophthalmic Terminology and Anatomy:
- Understanding ophthalmic anatomy and physiology.
- Learning common ophthalmic conditions and diseases.
- Familiarization with ophthalmic terminology and abbreviations.
3. Coding Guidelines and Documentation:
- Understanding coding guidelines and conventions.
- Reviewing documentation requirements for ophthalmic procedures and services.
- Identifying key elements necessary for accurate coding and reimbursement.
4. Ophthalmic Coding Systems:
- Understanding the Current Procedural Terminology (CPT) coding system.
- Familiarization with the International Classification of Diseases (ICD) coding system.
- Learning the Healthcare Common Procedure Coding System (HCPCS).
5. Evaluation and Management (E/M) Services:
- Understanding the E/M coding guidelines specific to ophthalmology.
- Identifying the key components of E/M services and assigning appropriate codes.
- Reviewing documentation requirements for E/M services.
6. Surgical Procedures and Services:
- Coding for common ophthalmic surgical procedures, such as cataract surgery, corneal transplant, and glaucoma procedures.
- Understanding modifiers and their application in ophthalmic coding.
- Familiarization with surgical documentation requirements.
7. Diagnostic Testing and Imaging:
- Coding for ophthalmic diagnostic tests and imaging procedures, including visual field tests, optical coherence tomography (OCT), and fundus photography.
- Familiarization with coding guidelines and documentation requirements for diagnostic testing.
Exam Objectives:
The OCS test focuses on evaluating the candidate's knowledge and understanding of the following key areas:
1. Ophthalmic Coding Guidelines and Conventions
2. Ophthalmic Terminology and Anatomy
3. Evaluation and Management (E/M) Services Coding
4. Surgical Procedures and Services Coding
5. Diagnostic Testing and Imaging Coding
6. Reimbursement Policies and Regulations
Exam Syllabus:
The test syllabus for the OCS certification provides a detailed breakdown of the syllabus covered in each test objective. It includes sub-topics, coding scenarios, and specific coding guidelines that candidates should be familiar with. The syllabus may cover the following areas:
- Ophthalmic surgical procedures and coding
- Ophthalmic diagnostic testing and imaging procedures
- Evaluation and management (E/M) coding in ophthalmology
- Coding guidelines and conventions specific to ophthalmology
- Reimbursement policies and regulations for ophthalmic coding
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OCS
Ophthalmic Coding Specialist
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Question: 38
Which of the following is always the payer of last resort?
A. Medicare
B. Medicaid
C. Worker’s Compensation Insurance
D. Commercial Insurance
Answer: B
Medicaid is always the payer of last resort. This means that if a patient has more
than one type of insurance coverage, and one of the insurances is Medicaid, then
the biller must bill the other insurance first and Medicaid second. Medicaid will
never pay first, if the patient has more than one type of insurance coverage.
Question: 39
HCPCS J-Codes are used to represent:
A. Drugs administered by methods other than the oral method
B. Durable medical equipment
C. Dental procedures not found in the CPT manual
D. Temporary national codes for Medicare
Answer: A
HCPCS J-Codes are used to represent drugs administered by methods other than
the oral method. The J-codes are used to bill drugs administered to the patient,
while in the office. Other sections in the HCPCS manual represent durable
medical equipment and temporary national codes. Dental procedures are not
represented at all in the CPT manual, and are reported with D-codes.
Question: 40
What does HIPAA stand for?
A. Health Insurance Portability and Accountability Act
B. Health Insurance Protection and Accountability Association
C. Health Insurance Post-Payment Auditing Association
D. Health Insurance Accountability and Auditing Act
Answer: A
HIPAA stands for Health Insurance Portability and Accountability Act. HIPAA is
an Act of Congress, not an association or organization. Those that do not follow
HIPAA requirements can be prosecuted. HIPAA also joins with other
organizations to ensure that everyone involved in patient healthcare follow its
stipulations.
Question: 41
Appendix 1 in the HCPCS Level II manual contains:
A. An alphabetized list of HCPCS modifiers
B. A table of drugs
C. A list of changes, additions, and deletions
D. A short list of CPT codes to use with HCPCS codes
Answer: B
Appendix A in the HCPCS Level II manual contains a table of drugs. This table
lists all of the drugs in alphabetical order and can be found in the HCPCS manual.
The listings are also organized according to the drugs administration route and
unit information.
Question: 42
In order for a physician to appropriately code for a consultation service, three
things must be documented. What are those three things?
A. The referral or request from the PCP, the rendering of the opinion by the
specialist or consultant, and the written report or findings sent from the specialist
to the PCP
B. The rendering of the specialty service to the patient, the referral of the patient
from the specialist to an additional specialist, and the written report of the
findings provided to the specialist
C. The specialist request of a second opinion regarding the patient, the PCP’s
advice regarding which second specialist the patient should see, and the second
specialist’s report or findings
D. The referral from the PCP to the specialist, an additional referral from the
specialist to another specialist, and the written report or findings sent from the
specialist to the PCP
Answer: A
In order for a physician to appropriately code for a consultation service, three
things must be documented. These three things are: the referral or request from
the PCP, the rendering of the opinion by the specialist or consultant, and the
written report or findings sent from the specialist to the PCP. These three things
can be easily remembered by the “Three R’s:” “Referral to Specialist,”
“Rendering of Service” and “Report to PCP.”
Question: 43
When listing both CPT and HCPCS modifiers on a claim, you:
A. List the HCPCS modifier first
B. Do not list the HCPCS modifier at all
C. Only list the CPT modifier
D. List the CPT modifier first
Answer: D
When listing both CPT and HCPCS modifiers on a claim, you list the CPT
modifier first. When you report a procedure code with more than one modifier,
you must list the modifier that will affect the payment first on the claim.
Typically, CPT modifiers will affect the payment of a claim, but HCPCS
modifiers may not.
Question: 44
In the RBRVS calculation, the GPCI takes into account:
A. The geographic location of a practice or provider
B. The type of provider specialty
C. The malpractice risk of a procedure
D. The overhead cost of the practice
Answer: A
In the RBRVS calculation, the GPCI takes into account the geographic location of
a practice or provider. GPCI stands for Geographic Practice Cost Index, and it
takes into account the relative price differences in geographical location. The
GPCI is a part of the RBRVS (Resource Based Relative Value Scale), which
calculates a reasonable fee for procedures.
Question: 45
HIPAA was created to:
A. Protect patient privacy
B. Enact ways to uncover fraud and abuse
C. Create standards of electronic transactions
D. All of the above
E. Only options A and B
Answer: D
All of the above, HIPAA was created to protect patient privacy, enact ways to
uncover fraud and abuse, and to create standards of electronic transactions.
HIPAA protects patient privacy through its strict standards of confidentiality,
allows organizations like the OIG to uncover fraud and abuse, and gives these
organizations the power to investigate and prosecute suspected fraud and abuse
cases. HIPAA also creates standards of electronic transactions, such as the ANSI
5010 update and requires encryption and passwords on websites that contain
patient data.
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FundamentalVR announced today that it teamed up with the American Academy of Opthalmology on virtual reality (VR) medical training.
The two combined for the Knights Templar Eye Foundation (KTEF) Pediatric Ophthalmology VR Simulation Program. They call it a significant step toward revolutionizing pediatric ophthalmic training, according to a news release.
Together, FundamentalVR and the Academy aim to harness the power of VR through a free and open simulation program. The program targets ophthalmologists and ophthalmology trainees worldwide. FundamentalVR and the Academy have already worked together over the past year to develop the educational platform.
The companies expect their initiative to offer a range of specialized training programs focused on pediatric eye diseases and conditions. Phase one centers around building a simulator for retinopathy of prematurity (ROP). Residents, trainees and practicing ophthalmologists will learn how to examine patients. They’ll also perform intravitreal injection and laser treatment in a safe environment through VR.
Phase one of this initiative focuses on building a simulator for retinopathy of prematurity (ROP). Residents, trainees, and practicing ophthalmologists will learn how to examine patients and perform intravitreal injection and laser treatment, all in a safe environment through VR.
“We are thrilled to be working with the American Academy of Ophthalmology on this transformative venture. Our collaboration with the Academy not only underscores our commitment to advancing the field of ophthalmology but also highlights the immense potential of VR in creating safer, more effective learning environments for healthcare professionals,” said Richard Vincent, co-founder and CEO of FundamentalVR. “Together, we aim to equip ophthalmologists with the skills and confidence needed to provide exceptional care to patients around the world, ultimately improving patient outcomes and enhancing the quality of eye care globally.”
The Master's in Clinical Vision Science Program consists of two program years of 7 and 1/2 class credits, two extended clinical practica plus a thesis in an area of vision research. Graduates earn MSc in Clinical Vision Science. MSc in Clinical Vision Science includes a concurrent Graduate Diploma in Orthoptics and Ophthalmic Medical Technology.Â
Graduate Diploma option: All candidates must apply to the Master’s Program. They, however, may opt to graduate with Graduate Diploma upon completion of all course work and practical training, without the thesis research component (VISC 9000.00).
Educational material is delivered in class format regading theoretical foundations, as well as through laboratory and supervised practical clinical training. Teaching follows a sequence that reflects increasing complexity and effective integration of the acquired knowledge and skills. Â
Course list
For course descriptions please click the name of the course that you want to view. Â
Year 1
Semester 1 - Fall Term
Semester 2 - Winter Term
Semester 3 - Summer Term Â
Year 2
Semester 1 - Fall Term
Semester 2 - Winter Term
Semester 3 - Summer Term
Year 3
Interprofessional Health Education
Students are required to maintain enrolment in IPHE 5900.00 in the fall and winter terms of both the first and second years of their academic studies. Successful completion of this class is a requirement for graduation, and will be recognized with the awarding of a special Certificate in Interprofessional Collaboration to be presented by the Faculty of Health. Specific guidelines and expectations regarding the portfolio required for compltion of IPHE 5900.00 are directed by every School/Program.Â
Practicum/Fieldwork Placements Â
Students enrolled in entry-to-practice graduate programs of study in the Faculty of Health may do some of their required clinical fieldwork at sites outside Halifax. It is the clinical sites' responsibility to provide access to adequate supply of ophthalmic equipment as required by the Program and to make a study/office place available for them. Students are advised that they may have to incur additional personal expenses for travel and temporary accommodation. Â
Â
All students in public schools will have medical cover paid for by the Government.
The Government will allocate Sh1,999 per child per year under the medical and insurance allocation. Parents will not contribute any monies towards this vote head.
In addition, all school property will be insured to save parents from shouldering the huge losses institutions incur during unrest.
According to the guidelines for the implementation of free day secondary education released by the Ministry of Education, the medical and property insurance vote head will take care of group emergency cover injuries, accidents and last respect, emergency drugs, first aid kits and medical cover for students.
Currently, schools have their own medical and insurance arrangements.
The details emerged as the Government announced increased capitation per child by Sh9,374 per year.
This brings to Sh22,244, the total amount the Government will now release per child per year in all secondary schools.
This means that the day schools fees will be fully catered for while boarding schools are set to charge a between Sh40,000 and Sh53,000.
The document says that parents will parents will only be required to buy school uniforms for their children, meet lunch costs and boarding-related levies.
Sources familiar with the details said the Ministry will from next year keenly monitor learners' medical cover and schools insurance plans.
The guidelines further reveal that firms identified with the support of the Insurance Regulatory Authority will insure all schools properties.
A Ministry of Education report released this year finds that last year alone, 483 incidents of student unrests were reported.
Medical and insurance covers are among the many vote heads that the government will subsidise in secondary schools.
The guidelines seen by The Standard lists all the vote heads and allocates the amount to be paid by the Government and how it shall be utilised.
The key vote heads are teaching and learning materials, repairs and maintenance, local travel and transport and all administrative costs of schools.
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Electricity, water, activity fees, personal emoluments, medical costs and insurance have also been listed.
Strict ways
A finer look at the details reveal that the ministry has spelt strict ways how the monies sent to schools will be spent per vote head.
Administrative costs vote head will strictly cover office stationary, communication and postage, telephone bills, printing of receipts, cash books, Local purchase orders, ledger books and non-teaching staff uniforms/equipment.
The money will also be used to service machines, letterheads, internet, bank charges, annual general meetings, prize-giving days and medical examination of food handling staff.
Local transport and travels vote heads will cater for travel and accommodation for school management officials, teachers, vehicle maintenance and educational tours.
The repairs and maintenance vote head will cover school, improvement such as paints, nails, cement, repairs of desks and chairs, window panes, lawns mowers, repair of roofs, fences, brooms, drainage.
Vote head
Electricity, water and conservancy vote head, according to the guidelines, will cover the utility bills, sewage plumbing, boreholes, electrical fittings, solar panels, maintenance, fuel, emptying septic tanks and purchase of gas.
And the personal emoluments vote head will take care of monthly salaries and allowances, social security, NHIF, service gratuity for non-teaching staff and work injury benefits.
In addition to these, each student will be issued with a receipt that reflects the amount of money send to the learner by the Government.
Shaping the Future of Ophthalmology: The Academy and FundamentalVR Spearhead a Groundbreaking VR-Powered Clinical Education Initiative to Transform Ophthalmic Training
SAN FRANCISCO, Nov. 3, 2023 /PRNewswire/ -- The American Academy of Ophthalmology has teamed up with FundamentalVR, a leader in virtual reality (VR) medical training, for their Knights Templar Eye Foundation (KTEF) Pediatric Ophthalmology VR Simulation Program. This collaboration, made possible by a generous $5 million donation from the Knights Templar Eye Foundation, marks a significant step towards revolutionizing pediatric ophthalmic training by harnessing the power of VR technology through a free and open simulation program for ophthalmologists and ophthalmology trainees worldwide.
In the past year, the Academy and FundamentalVR have made significant strides in the development of this pioneering educational platform. With a goal to Excellerate the skills of ophthalmologists and expand their knowledge base, this initiative will offer a range of specialized training programs focused on pediatric eye diseases and conditions.
"The potential to Excellerate training programs is huge," said Faruk H. Orge, MD, executive editor of the KTEF Pediatric Ophthalmology Education Center. "Just as virtual reality has greatly enhanced the experience of video games, so can being immersed in a virtual surgical training environment. Studies show that it allows residents to learn details more efficiently and effectively, leading to a decrease in complications in real cases with real patients. There is simply no substitute to performing a task again and again to master the basics. These platforms provide a safe, lifelike environment in which trainees can practice as much as they want, with real-time feedback that allows for course correction."
Phase one of this initiative focuses on building a simulator for retinopathy of prematurity (ROP). Residents, trainees, and practicing ophthalmologists will learn how to examine patients and perform intravitreal injection and laser treatment, all in a safe environment through VR.
"ROP is a natural first choice for this effort because it is the leading cause of preventable blindness in children worldwide," said K. David Epley, MD, deputy executive editor of the KTEF Pediatric Ophthalmology Education Center. "At the same time, the opportunity for trainees to learn how to properly examine and treat babies is limited. Outside of the U.S. many countries don't allow residents to perform any pediatric surgeries, so there's huge need for the ability to practice and learn proper techniques."
The Academy has chosen to partner with FundamentalVR, recognized for its transformative work with organizations like Orbis International, to design and build a specialized curriculum for pediatric eye care. Following the ROP simulator, subsequent modules will address strabismus management and other critical pediatric ophthalmology topics.
"We are thrilled to be working with the American Academy of Ophthalmology on this transformative venture. Our collaboration with the Academy not only underscores our commitment to advancing the field of ophthalmology but also highlights the immense potential of VR in creating safer, more effective learning environments for healthcare professionals," said Richard Vincent, co-founder and CEO of FundamentalVR. "Together, we aim to equip ophthalmologists with the skills and confidence needed to provide exceptional care to patients around the world, ultimately improving patient outcomes and enhancing the quality of eye care globally."
AAO 2023Â attendees (Nov. 3 - 6) can experience a live demonstration of the VR platform at the Resource Center, Moscone West Expo, Booth 7537.
Moscone West Expo, Booth 7537
- Saturday, Nov. 4 and Sunday, Nov. 5, from 9 a.m. to 5 p.m.
- Monday, Nov. 6, from 9 a.m. to 3:30 p.m.
FundamentalVR, Booth: 5504
To learn more about the collaboration please visit: aao.org and fundamentalvr.com
About the American Academy of Ophthalmology
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, we protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public. We innovate and support research to advance our profession and to ensure the delivery of the highest-quality eye care. Our EyeSmart® program provides the public with the most trusted information about eye health. For more information, visit aao.org.
About FundamentalVR
Global leader in immersive surgical training, FundamentalVR was founded with the mission to accelerate human capability in surgery and medicine by using virtual technologies and created to transform traditional surgical training methods through VR, precision simulation, and a patented kinesthetic haptic system with data, artificial intelligence, and multimodal learning. Its Fundamental Surgery platform allows for full rehearsal of medical and surgical procedures, and its patented HapticVR™ technology mimics the physical touch of surgical actions. The platform's unlimited multi-user capabilities and mixed modalities work individually or together for each business case, accelerating the time in which products and procedures can be brought to market and Excellerate patient outcomes, resulting in FundamentalVR's platform being the only immersive training solution accredited by leading global education institutions such as the AAOS and the Royal College of Surgeons of England. For more information, please visit FundamentalVR.com
View original content to download multimedia:https://www.prnewswire.com/news-releases/american-academy-of-ophthalmology-and-fundamentalvr-collaborate-on-virtual-reality-initiative-to-improve-ophthalmic-training-around-the-world-301977104.html
SOURCE FundamentalVR
Data coverage:
Data encompasses B2B, B2G, and B2C spend. Figures are based on medical devices and IVD revenues allocated to the country where the money is spent at manufacturer price levels excluding VAT.Modeling approach / Market size:
Modeling employs a top-down approach with a bottom-up validation, using financial information of the key players by market. Market sizes are determined by a top-down approach, based on a specific rationale for each market market and allocated to the covered countries according to the global market shares. As a basis for evaluating markets, we use relevant key market indicators and data from country-specific associations, such as healthcare expenditure per capita, health risk factors, healthcare system, and regulations concerning medical products. Next, we use further relevant key market indicators and data from country-specific associations, such as healthcare expenditure per capita, health risk factors, healthcare payer system, and regulations concerning medical products. This data helps us estimate the market size for each country individually.Forecasts:
In our forecasts, we apply diverse forecasting techniques. The selection of forecasting techniques is based on the behavior of the particular market. For example, forecasts are based on historical developments, current trends, and key market indicators.Additional notes:
Data is modeled in US$ using current exchange rates. The market is updated twice per year in case market dynamics change. The impact of the COVID-19 pandemic is considered at a country-specific level.Data coverage:
Data encompasses B2B, B2G, and B2C spend. Figures are based on medical devices and IVD revenues allocated to the country where the money is spent at manufacturer price levels excluding VAT.Modeling approach / Market size:
Modeling employs a top-down approach with a bottom-up validation, using financial information of the key players by market. Market sizes are determined by a top-down approach, based on a specific rationale for each market market and allocated to the covered countries according to the global market shares. As a basis for evaluating markets, we use relevant key market indicators and data from country-specific associations, such as healthcare expenditure per capita, health risk factors, healthcare system, and regulations concerning medical products. Next, we use further relevant key market indicators and data from country-specific associations, such as healthcare expenditure per capita, health risk factors, healthcare payer system, and regulations concerning medical products. This data helps us estimate the market size for each country individually.Forecasts:
In our forecasts, we apply diverse forecasting techniques. The selection of forecasting techniques is based on the behavior of the particular market. For example, forecasts are based on historical developments, current trends, and key market indicators.Additional notes:
Data is modeled in US$ using current exchange rates. The market is updated twice per year in case market dynamics change. The impact of the COVID-19 pandemic is considered at a country-specific level.OCS PDF Download | OCS helper | OCS questions | OCS learner | OCS syllabus | OCS test Questions | OCS history | OCS book | OCS test | OCS test plan |
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