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R. Seitzman, F. Yu, A.L. Coleman; Cost of Blindness in Patients with Age–Related Macular Degeneration in the Medicare Population . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1412.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To explore the healthcare costs associated with blindness in patients with age–related macular degeneration (ARMD) in the Medicare population. Methods: Billing data from all patients who were coded with ARMD (ICD–9: 362.50, 362.51, 362.52, 362.57) in 1999 in the 5% random sample of the Medicare database (Health Care Financing Administration Physician/Supplier Part B Files) were obtained. ARMD patients were excluded if they were under 65 years of age, did not reside in the United States or the District of Columbia, did not have Part–B coverage, or had HMO coverage that was not processed by HCFA. Blindness was determined by the ICD–9 diagnosis code for blindness (369.xx). All eye–related visits in 1999 were then extracted for each ARMD patient from the Medicare database to determine the annual allowed reimbursement. Annual allowed reimbursement for a subset coded with eye codes only (CPT: 92002, 92004, 92012, 92014, 92015, 92020, 92225, 92226) was also calculated. Wilcoxon tests were used to assess the difference in costs between ARMD patients coded with and without blindness. Results: In 1999, 94,821 patients were coded for ARMD and 2,103 (2.2%) of them were coded for blindness. During 1999, the median annual allowed reimbursement for all eye–related visits was $292 (mean $689 ± $1016) for ARMD patients coded for blindness and $130 (mean $421 ± $772) for ARMD patients not coded for blindness (p<0.001). The median annual allowed reimbursement for the subset of eye–codes was $75 (mean $113 ± $138) for ARMD patients coded for blindness and $64 (mean $87 ± $92) for ARMD patients not coded for blindness (p<0.001) Conclusions: In 1999, Medicare patients with diagnosis codes for ARMD and blindness had a significantly higher reimbursement amount for all eye–related visits and eye codes than ARMD patients not coded for blindness.
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