Optometry Coding & Billing Alert
Check Policy for Pachymetry
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Question: What code should I use for pachymetry? Answer: Report CPT code 76514 (Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral [determination of corneal thickness]).
Massachusetts Subscriber
Pay special attention to the phrase "unilateral or bilateral" in the description - this phrase tells you to report the code only once, whether you perform the test in one or both eyes.
Smart idea: Ask your carrier about its policy for 76514. Many carriers will only reimburse for pachymetry once in a lifetime for each patient per doctor. The pachymetry never changes, they say, so they won't allow it more than once. However, carriers may allow more frequent claims for patients with certain corneal conditions, such as Fuchs' dystrophy.
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