Optometry Coding & Billing Alert
EOM Function Test
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Question: My optometrist wants to code for a “detailed evaluation of EOM function.” The diagnosis was “convergence insufficiency.” Is there a code for this? Can we code it with an eye exam?
Washington Subscriber
Answer: You can report 92060 (Sensorimotor examination with multiple measurements of ocular deviation [e.g., restrictive or paretic muscle with diplopia] with interpretation and report [separate procedure]) on the same day as an eye exam (92002-92014) or E/M code (except 99211). Optometrists perform the test to look for focusing or accommodative problems in extraocular muscle (EOM) function. Common diagnosis codes for this test are 378.1x (Exotropia) and 378.0x (Esotropia). Convergence insufficiency, accommodative insufficiency and divergence excess diagnoses would be covered under the exotropia diagnosis. Keep in mind that you may need to append modifier 25 to the E/M and must have supporting documentation for the separate E/M.
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