Optometry Coding & Billing Alert

Published on Mon Jun 15, 2009 PDF

Question: How often can a gonioscopy test be performed on a patient?

New Jersey Subscriber

Answer: The frequency of gonioscopy examinations (92020, Gonioscopy [separate procedure]) carried out on glaucoma suspect patients largely depends on medical necessity to justify such tests. The frequency of test that may be performed and filed for reimbursement is a common concern expressed by physicians. The American Optometric Association recommends an annual dilated eye examination for people at risk for glaucoma as a preventive eye care measure. Depending on your specific condition, your doctor may recommend more frequent examinations. Optometrists may repeat gonioscopy periodically every one to five years.

A follow-up test is necessary upon evidence of new symptoms, progressive disease, new findings, unreliable prior results, or a change in treatment plan. As a rule, additional testing is justified when the information garnered from the eye examination is not adequate to assess the patient's disease completely.

Watch out: If a patient has a history of glaucoma and the ocular examination reveals an unstable or worsening condition, then more extensive testing may be justified. A patient with a stable visual field is less likely to file a claim than someone with a controlled condition.