Welcome to Optometry Simplified.
In this weekly newsletter, I've curated the best resources to help you grow personally and professionally.
My mission is to find what's best for my patients and my practice.
Here's what I've found...
Links I Liked
I didn't plan to do pediatric care.
But I realized my preferences weren't as important as my responsibility. Two excellent recent articles from are worth a read for any OD who has taken on the responsibility of pediatric eye care: Questions and Controversies in Pediatric Prescribing and Managing Binocular Vision and Pediatric Eye Conditions. Review of Optometry
All things traumatic glaucoma
These are the articles I love. Short enough to read in 20 minutes or less, but detailed and thorough enough to provide a great review and update on a particular topic. Devyn Moran Glover, OD, wrote just that about traumatic glaucoma. Eyes On Eyecare
Research I'm Reading
Just because it is correlated doesn't mean it's causative, but...
A recent study identified 30 different systemic drugs associated with increased risk of rhegmatogenous retinal detachment (RRD). Eye (Nature) Summary from Review of Optometry
Epi-on corneal crosslinking was recently approved. Now's the time to read about it.
A good article summarizing the trials comparing epi-on vs epi-off corneal crosslinking was published about a year ago. This is a good place to start before we get full access to the data involved in the FDA approval of Epioxa. Clinical Ophthalmology
Deep Thoughts
Most optometrists don’t undercode because they’re lazy or careless.
They undercode because they’re afraid.
Afraid of audits.
Afraid of appearing greedy.
Afraid of their patients.
Or even scared that their staff might think they’re “overcharging.”
So we default to the safe middle ground: the 99213. Over and over again.
In most practices, the ratio of 99213 to 99214 visits is somewhere between 5:1 and 10:1. (We've audited practices where that value is ~100:1!)
But in a full-scope medical optometry practice, it should be closer to 1:1.
That’s not about “gaming the system.” It’s about reflecting reality.
If you’re managing chronic disease, interpreting diagnostic data, adjusting treatment plans, and coordinating care, you are likely performing level 4 care more often than you think.
Here’s the uncomfortable truth: chronic disease care delivered and documented as 99213s is undercoding, plain and simple. And it doesn’t just cost revenue; it perpetuates the story that optometric medicine isn’t worth much.
So what do we do about it?
- Learn the codes. Coding confidence comes from understanding why a visit qualifies, not memorizing grids.
- Template for decision-making. Build EMR prompts that capture risk, data, and management—the three pillars of medical decision-making.
- Audit yourself quarterly. Pull ten charts. Score them objectively. Most doctors find that at least half of their 99213s actually justify a 99214.
- Lead with integrity, not insecurity. Correct coding is ethical billing.
When we stop coding from fear and start coding from clarity, we stop discounting the very care we worked so hard to provide.
This is what practicing comprehensive optometry looks like, owning the value of your medical care, one code at a time.
👉 Book a coaching session with one of our experts to audit your coding patterns, improve documentation, and build confidence in billing the care you already deliver.
Disclaimer: There should be no difference between the level of care you provided and the documentation of that care in your EHR. But the documentation MUST reflect that care for you to be able to code for it. That is your responsibility.
Practice Performance Partners Pick
Most optometrists assume getting credentialed is just a paperwork formality, but Joe DeLoach, OD, FAAO reveals how much that assumption can cost you.
If you’ve ever wondered whether your credentialing setup could quietly be limiting your insurance reimbursements or even your liability protection, you’ll want to read this one.
Can you do me a favor? If you found any of these resources helpful, share this newsletter with one of our colleagues!
See you next week!
--Kyle Klute, OD, FAAO