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I noticed the OfficeMate Knowledge Base had this update for us about certain CPT codes:

In the 2011 CPT Coding Manual, which is effective January 1, 2011, CPT code 92135 has been deleted and replaced with the following codes:

• 92132 – Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report, unilateral or bilateral (Replaces 0187T)
• 92133 – Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve
• 92134 – Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina

I like that because I hate having to remember modifiers like RT and LT, especially on tests that are most always run bilaterally anyway. I’m sure the insurance companies will like it for stats because it’s more descriptive by differentiating optic nerve vs. anterior segment vs. posterior segment.

UPDATE: Chuck Brownlow has more on this code change along with fiscal impacts.

I have previously announced my intention to dump OfficeMate because I didn’t want to spend close to $1000 updating my server software from WSBS2003 to WS2008R2-standard for the version 9 upgrade (and that’s in addition to the painful yearly software agreement fee).

Well, now I’m not so sure. All I need is for something to easily enter data and claims, export an ANSI 837 file, and include a ledger, receipts, and reports system so that I can easily see my accounts recievable.

Well, apparently that’s too much to ask because I have test driven several competitors, and believe it or not, their interfaces are actually worse than OfficeMate’s!. Several of them won’t export a simple ANSI 837 file to upload to a clearing house like Apex. Maybe it’s just because I’m used to the OfficeMate system after four years. I can quickly do all my insurance billing and receipts myself (no paid help) in OM8. Of course, so far this year I only bill insurance for 27% of my exams, which is close to average for my practice profile.

So if I abandon OM for another system, it’s going to take me way more time to process claims and figure out accounts receivable. With Walmart getting into the Medicaid game on glasses, now I’m sure I’ll have even more insurance to bill in 2011. So, as of now, I am leaning towards biting the bullet and doing what it takes to upgrade to OfficeMate 9.

An interesting topic is how many mouse clicks per patient one needs in EHR/PIM software. A doc at EHR Compare forum reports that it takes his office 200 clicks per patient in OfficeMate. Is it any wonder that many docs think EHRs are not ready for prime time? (Example 1, 2, 3)

Why hasn’t someone created a free or cheap, open sourced PIM/EHR that is easily navigable? I tried OpenEMR (which you can install on a windows machine using XAMPP), but it was confusing how to create charges with attached ICD9 and CPT codes, let alone create an ANSI 837 file.

OfficeMate historically has not allowed the use of the scroll wheel in its applications, which is totally stupid. Using the mouse’s scroll wheel really speeds up my data entry.

Somewhere along the way between 2006 and now I think they fixed this issue in ExamWriter because my plain vanilla Dell computer with its USB mouse with scroll wheel is now able to wheel scroll in ExamWriter 7.4.2 (EDIT: A simple search of my own website reveals that starting with 7.4 they enabled ExamWriter wheel scrolling). It still isn’t fixed in OfficeMate’s third party billing application. When I want to do “CMS Maintanence” for a claim (that’s technical talk for manually updating fields in a HCFA-1500), it doesn’t allow scrolling with the wheel.

Thankfully, there is an application called KatMouse. I heard about it from Steve Gibson and Leo Laporte’s podcast, Security Now. This small application enables scrolling for most every application. I installed it, and now I can scroll with the mouse’s wheel when editing a HCFA.

Thank you, KatMouse! Shame on you OfficeMate.

By the way, OfficeMate. Do you really think it’s a good idea to charge $1200+ per year for the “Annual Software Maintenance Agreement” (ASMA)? It feels like extortion. I mean, some less scrupulous optometrist could pay a kid less than $1200 to crack your ASMA, and then where would you be? (Not that any optometrist would be that unethical, but I’m just sayin’.) If I pay several thousand dollars for the program in the first place, I think I should be able to use it without strings attached. Instead of disabling editing of all records, why not just disable stuff like VisionWeb? Or maybe make your money off of established clients by charging for new features/upgrades. (Still provide security fixes for free).

Sooner or later someone is going to come up with a really nice, free, open-source optometry practice management system using PHP and MySQL on a Linux box. When that happens, watch out, OfficeMate.