Ophthalmology and Optometry Coding Alert

Question: Should I bill for gonioscopy during the postoperative period of cataract surgery? Nevada Subscriber Answer: Yes. Testing services are excluded from the global surgical package. The gonioscopy (92020) is unrelated to the cataract surgery (66830-66986) unless the viscoelastic agents used in the cataract surgery have affected the trabecular meshwork. If testing services are related to the cataract surgery, do not bill for them. If the surgery was a trabeculectomy (66170, 66172), billing for the gonioscopy in the postoperative period is highly questionable because that is included in the postoperative care. The same can be said for extended ophthalmoscopy after a progressive retinopathy (67228,Destruction of extensive or progressive retinopathy [e.g., diabetic retinopathy], one or more sessions; photocoagulation [laser or xenon arc]) or a buckle (67107, Repair of retinal detachment; scleral buckling [such as lamellar scleral dissection, imbrication or encircling procedure], with or without implant, with or without cryotherapy, photocoagulation, and drainage of subretinal fluid). If the physician looked at the operative site to assess the status following surgery, those visualizations should probably be included in the global fee.