AOA clarifies meaningful use rule on electronic order entry
Certified paraoptometric staff may perform computerized provider order entry (CPOE) to fulfill meaningful use requirements, per a clarification from AOA reinforcing the benefits of AOA associate membership.
Based on AOA's review of the regulations and guidance from the Centers for Medicare & Medicaid Services (CMS), AOA recommends that doctors of optometry only allow credentialed staff members, with designations such as Certified Paraoptometric Technician (CPOT), Certified Paraoptometric Assistant (CPOA) and Certified Paraoptometric (CPO), to enter orders related to CPOE.
The AOA recently clarified with CMS that doctors of optometry are responsible for determining which credentialed staff members, if any, are qualified to perform the CPOE function as a meaningful use measure in the Medicare & Medicaid Electronic Health Records (EHR) Incentive Programs. CMS reiterated that the agency is "neither qualified nor authorized to make a determination," but referred to August 2013 guidance that states "appropriately credentialed" staff can perform the function and have it count toward the measure.
Given that CMS specifically indicates "laypeople" are unqualified to perform duties associated with CPOE and that those selected to assist must be certified by organizations other than the employer, ensuring that staff members tasked with entering orders receive additional training and certification—such as CPOT, CPOA or CPO—would be a positive first step.
Paraoptometric certification is a program developed by a respected panel of AOA paraoptometrics and doctors of optometry to encourage paraoptometric continuing education and knowledge in the field of optometry. Administered and prepared by the Commission on Paraoptometric Certification (CPC), examinations-accredited by the National Commission for Certifying Agency (NCCA)-assure a level of knowledge appropriate for the functions of each certified designation.
To ensure staff are best prepared for paraoptometric certification, AOA member doctors can enroll their staff as AOA associate members—at no extra cost to the member-doctor or staff—to access key developmental tools and resources through the AOA Paraoptometric Resource Center. And consider discussing paraoptometric certification with your team this week as practices nationwide celebrate Paraoptometric Recognition Week.
In addition to designating certified paraoptometrics to perform CPOE, AOA recommends documenting how those individuals were determined qualified to enter such orders. This documentation should include the individual's paraoptometric credentials, specific experience, education or training that might be relevant, information about the workflow used in the office to enter orders, and compliance with any pertinent local, state or federal laws. This information will be helpful in the event that a doctor is audited related to the EHR Incentive Program.
Changes in coding and reimbursements worth knowing. Meanwhile, with the clock winding down on 2024, the AOA continues to press for Congress to act on reforms that would give doctors of optometry an annual, permanent inflationary Medicare payment tied to the Medicare Economic Index.
The federal government and private payers are heavily scrutinizing the use of modifier -25. When used appropriately, it can help to ensure that patients receive appropriate treatment and that doctors of optometry are reimbursed appropriately for their service. If you believe a claim that includes modifier -25 was inappropriately denied, follow appropriate criteria when appealing.