Optometry Coding & Billing Alert

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Coding OCB/A-Scan Combos

Question: An established Medicare patient reports to the optometrist for an optical coherence biometry (OCB) and an A-scan on his right eye. Can we report codes for both services?

Alabama Subscriber

Answer: The Correct Coding Initiative (CCI) forbids coding these services together. According to the edits, codes 76519 (Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation) and 92136 (Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation) are mutually exclusive edits.

On the claim, report 92136 with modifier RT (right side) appended to represent the area the doctor worked on. CCI bundles the A-scan service represented by 76519 into 92136.

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