Optometry Coding & Billing Alert

Published on Wed Jan 27, 2010 PDF

Question: I'm confused about coding for visual fields (VF). The code description says "unilateral or bilateral." Would the coding and modifiers for a VF done on one eye be different for a VF done on both?

Mississippi Subscriber

Answer: Yes, you'll need a modifier on a unilateral VF, but not on a bilateral one.

Although the definition for 92081-92083 (Visual field examination, unilateral or bilateral, with interpretation and report ...) seems to cover both bases, Medicare views visual field tests as inherently bilateral -- the optometrist usually performs the procedure on both eyes.

For a bilateral VF test, do not append any modifiers. The payment from Medicare will reflect the work performed on both eyes. If the optometrist performed a visual field test on only one eye, append modifier 52 (Reduced services) to 9208x.