Optometry Coding & Billing Alert

Published on Mon Sep 01, 2008 PDF

Question: Is there a code for a Schirmer's tear test other then the generic 92499? I have gone through the HCPCS manual and can't find anything.

Illinois Subscriber

Answer: There isn't any other code to use to report the service. Medicare considers the test, in which the optometrist inserts small slips of paper into the conjunctiva to measure tear production, included in the level of visit rendered, so you cannot use 92499 to report the service to Medicare or to bill the patient separately for it.

You can try using 92499 (Unlisted ophthalmological service or procedure) for other insurers, but many will not reimburse for the service.

What about supplies? There's no HCPCS code for the Schirmer's test materials, either. You can try coding 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) -- but to do that, you need to document the price of the supplies by sending in the invoice.

The cost of the postage (not to mention your time in putting the claim together) will probably be more than the cost of the Schirmer's strips.