Ophthalmology and Optometry Coding Alert

Question: Is there a code for interpreting a GDX?

New York Subscriber


Answer: According to the current CPT manual, code 92135 (scanning computerized ophthalmic diagnostic imaging [e.g., scanning laser] with interpretation and report, unilateral) would be used to report a GDX (GDX Nerve Fiber Analyzer and TopSS scanning laser technology) procedure including the interpretation of the procedure and the written report on one eye. If the ophthalmologist only performs an interpretation and writes a report, then append modifier -26 (professional component) to 92135 to indicate that only the professional component, the interpretation, was performed by the ophthalmologist.

When your office bills for the interpretation, make sure the office preforming the test bills for only the technical portion by using 92135-TC (-TC, technical component). If they bill for the entire procedure, they will need a reason for repeating the interpretation component. When a physician reviews a testing service during an office visit, the interpretation is not separately billable and is considered part of the E/M service level or eye code billed.