Cpt 2011 Provides Codes To Distinguish Between Optic Nerve And Retinal Scans

By Author: Angela Martin
Total Articles: 205
Comment this article

Disturbed by the lack of specificity in scanning laser coding? Then gear up for the coming year - 2011's CPT manual will not only help you distinguish between anterior and posterior segment scanning, but also provide just-in codes to distinguish between optic nerve and retinal scans.


Even though scanning laser ophthalmic diagnostic imaging (SCODI) is commonly used as a diagnostic test for early detection of glaucoma, it's also a valuable tool for the evaluation and treatment of individuals with retinal disease, counting individuals with diabetic retinopathy and macular degeneration. SCODI is able to detail the microscopic anatomy of the retina and the vitreo-retinal interface.


To distinguish between the two diagnostic purposes, CPT will do away with the old all-purpose posterior segment SCODI code, 92135 and replace it with these two new more specific codes:


92133
92134


Try this new code for anterior SCODI


CPT 2011 also introduces a new Category I CPT code for anterior segment SCODI:


92132


...
... This permanent code replaces a temporary code introduced a couple of years ago. CPT introduced temporary Category III code 0187T in year 2009. Anterior segment optical coherence tomography SCODI didn't fit under the existing posterior segment scanning code, 92135. Anterior and posterior segment scans use different wavelengths and require different machines.


Keep a lookout for bilateral coding changes


An important phrase to keep your eye on in the descriptors of these just-in codes is "unilateral or bilateral" -- replacing the word "unilateral" in the descriptor for 92135. This may signal a change in how Medicare will reimburse for SCODI performed on both eyes in 2011.


Presently, Medicare sees 92135 as inherently unilateral, assigning it modifier indicator '3' in the Physician Fee Schedule. If your optometrist performs 92135 on both eyes this year, you can bill 92135 bilaterally and anticipate to be paid fully for both eyes.


But with their code descriptors specifying 'unilateral or bilateral' Medicare may need you to bill 92133 or 92134 only once, irrespective of whether the test is carried out on one or both eyes. Medicare hasn't set payment values and restrictions on these codes as yet.


Welcome new remote imaging codes


If your practice is taking advantage of high-speed Internet access to share diagnostic images with retinal specialists in remote places, in the coming year, you can take advantage of two new codes:


92227
92228


A remote imaging system is capable of taking images of the retina with a wide-angle lens and transmitting them to a qualified retina specialist anywhere in the world. Remember that these codes too are specified as "unilateral or bilateral."


For more optometry coding updates, medical coding and stay tuned to an audio conference.
v