Ophthalmology and Optometry Coding Alert

Question: My ophthalmologist performed slit lamp photography and gonioscopy. Should I separately report these services or are they bundled together?

Montana Subscriber   Answer: Whether you can separately report external ocular photography, like slit lamp photography and gonioscopy, depends on the diagnosis code that is linked to each procedure.

Slit lamp photography, 92285 (External ocular photography with interpretation and report for documentation of medical progress [e.g., close-up photography, slit lamp photography, goniophotography, stereo-photography) includes gonioscopy (92020, Gonioscopy [separate procedure]), according to the National Correct Coding Initiative. So, you can circumvent this bundling only if the ophthalmologist has different reasons (represented in different, but both medically necessary, diagnosis codes) for performing each procedure.

For example, if an ophthalmologist performs a gonioscopy for glaucoma and takes slit lamp photographs to document a nevus iris, you can report the two services separately using modifier -59 (Distinct procedural service) and separate diagnosis codes and/or eyes. Link the glaucoma diagnosis code to 92020 and the iris nevus diagnosis code to 92285. You should also document the physician's findings and the status of the condition.

  Answers to You Be the Coder and Reader Questions provided by Raequell Duran, president of Practice Solutions in Santa Barbara, Calif.