Wiki Are 92235/40 unilateral or bilateral?

[Judy61048]

Does anyone know if code(s) 92235 and 92240 are bilateral or unilateral? My understanding is that the codes can not be billed with a 50 modifier, but can be billed with a 52 - LT or RT. This would lead me to believe they are bilateral. I am getting conflicting information from various sources and the coding books do not clarify if the codes are bilateral or unilateral. Any clarification is greatly appreciated! Thanks.

 

[dmcvinney]

They are billable per eye. We bill on two lines with RT on one line, LT on the other, unless the payor wants on one line. Make sure you're getting paid 100% of the allowable per eye.

 

[cmasters@ghs.org]

CPT book says differently.

They are billable per eye. We bill on two lines with RT on one line, LT on the other, unless the payor wants on one line. Make sure you're getting paid 100% of the allowable per eye.

According to the CPT 2017 Professional Edition and Corcoran, the description is "unilateral OR bilateral", meaning that you cannot bill for this code twice.

 

[CodingKing]

The code description changed in 2017 to make it unilateral or bilateral. Prior to 1/1/17 it was considered Unilateral with a bilateral indicator of 3 meaning 200% payment if done on both sides.