Optometry Coding & Billing Alert

Published on Sun Sep 27, 2009 PDF

Question: A patient pays a visit to the clinic for a routine eye exam in the morning. CPT 92014 and 92015 were used to code the encounter. He calls after lunchtime and says that his eye got poked with a branch. The physician examines him and fitted a bandage lens. How do I code this case to let the insurance carrier know that it was actually two different visits?

Philadelphia Subscriber

Answer: You can use ICD-9 CM diagnosis code 918.1 (Superficial injury of cornea) for the eye injury and 92070 for the fitting and supply of the bandage lens. You could also add code 99285 for anterior segment photography if it is performed.

To let the insurance provider know that a separate procedure has been performed on the same day, you should append modifier 25 to the evaluation and management code.