Ophthalmology and Optometry Coding Alert

Optometry/Ophthalmology Coding:

Use 92066 When a Vision Therapist Delivers Orthoptic Therapy

Question: I’m new to ophthalmology coding and I have a medical record for a patient who presented for exophoria treatment. A vision therapist in the ophthalmology practice provided orthoptic therapy, while the physician provided indirect supervision.

What codes should I report for the encounter?

Florida Subscriber

Answer: Assign 92066 (Orthoptic training; under supervision of a physician or other qualified health care professional) to report the orthoptic therapy. While the physician is not providing the service, the vision therapist is a qualified healthcare professional and is under the supervision of the physician. According to CPT® Assistant, Volume 36, Issue 6, “Often, the physician is unable to provide orthoptic training directly to a patient, which is when a clinical staff member would perform the services under the supervision of a physician or other qualified health care professional (QHP).”

A girl is sitting in front of a device for stimulating vision.

Next, you’ll turn to the ICD-10-CM code book to locate the exophoria diagnosis code. In the Alphabetic Index, look for Strabismus > heterophoria > exophoria. You’ll then verify the code in the Tabular List. Use H50.52 (Exophoria) to report the exophoria diagnosis and the reason for the orthoptic therapy.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC