Optometry Coding & Billing Alert

Published on Fri Jan 12, 2007 PDF

Finally, CPT adds a code for corneal topography

Optometry coders are reacting with cautious optimism to the new CPT code for corneal topography.

Why so skeptical?  It's a long-awaited addition to the code set but doesn't have much reimbursement attached to it. Take a look at the pros and cons of this latest addition to your CPT 2007 codes.

92025 Replaces 92499 in 2007

As of Jan. 1, you finally have a way to report corneal topographies that your optometrist performs, and it won't involve using an unlisted-procedure code.

Start using CPT 2007 code 92025 (Computerized corneal topography, unilateral or bilateral, with interpretation and report) for corneal topography, also known as corneal mapping or computer-assisted video keratography (CAVK).

In the past, you had to use unlisted-procedure code 92499 (Unlisted ophthalmological service or procedure) or S0820 (Computerized corneal topography, unilateral) depending on the insurance carrier, says Marsha Duggins, the senior billing specialist for Abrams EyeCare Associates in Indianapolis.

Caution: Before when you reported 92499 or S0820, you may have appended modifier LT (Left side) or RT (Right side) to specify which eye was tested because the procedure is considered to be unilateral. However, the new code descriptor specifies unilateral or bilateral, so you should report the code just once, and no modifier will
be necessary.

Money matters: -It is good news to finally have a code for corneal topography; however, reimbursement according to Medicare's 2007 fee schedule is $28, unadjusted, unilateral or bilateral,- says Dolores Berkery, practice manager of Gold Ophthalmologic Associates PC in Great Barrington, Mass. -It surely beats using the unspecified and doing all the documentation.-