Optometry Coding & Billing Alert
READER QUESTION ~ Don't Modify Nonconclusive HRT Claim
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Question: How should I code for a nonconclusive HRT? One of our patients had one done, but due to her cataracts, the optometrist was unable to get a clear reading. Should I report just the technical component of the code? Answer: Report 92135 (Scanning computerized ophthalmic diagnostic imaging [e.g., scanning laser] with interpretation and report, unilateral) for the Heidelberg Retina Tomograph (HRT) study. Report the global code without appending modifier TC (Technical component).
Florida Subscriber
In this case, your practice performed both the technical component and the professional component. Even if the provider could not make a final diagnosis based on the test, if he looked at the report and documents the findings, he gets credit for the professional component.
In the absence of a final diagnosis, report an ICD-9 code that describes the symptoms that prompted the test -- for example, 379.9x (Unspecified disorder of eye and adnexa), or 796.4 (Other abnormal clinical findings) if the patient has increased intraocular pressure, which could indicate glaucoma.
Optometry Coding & Billing Alert
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