Optometry Coding & Billing Alert

Published on Tue Jul 13, 2010 PDF

Question: As a retina office, we occasionally do visual fields. However, when I report 92082-LT and 92082-RT, I'm only getting reimbursed for one eye. According to CPT, the procedure is "unilateral or bilateral."

California Subscriber

Answer: CPT does say that the visual field codes, 92081-92083 (Visual field examination, unilateral or bilateral, with interpretation and report ...) are "unilateral or bilateral" -- but Medicare payers, and those that follow Medicare rules, don't see it that way.

Medicare's fee schedule gives codes 92081-92083 a bilateral indicator of "2," meaning that it sees the codes as inherently bilateral. CMS bases the relative value units (RVUs) assigned to 92081-92083 on the assumption that the optometrist performs the work in both eyes. So you should not append modifiers LT (Left side), RT (Right side), or 50 (Bilateral procedure) to the code when you report bilateral visual fields -- the payment from Medicare will reflect the work performed on both eyes.