Wiki E&M vs. Eye Exam Codes

lyon0023

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Good Morning,

Vermont Medicaid has placed a restriction on 92002/4 92012/4 eye exam codes. However, my understanding was that the eye exam service was not fundamentally uncodable as an E&M service using the 99--- office visit codes.

My understanding is that the 92--- codes exist to compensate for the fact an eye exam usually results in a very restricted review of systems, resulting in an artificially reduced level of E&M service. Thus, it is not incorrect coding that providers bill their eye exams as the 99--- codes, it is just in their best interest to use the 92--- codes, since they do not have to do a comprehensive review of systems when that is not a major part of the examination.

I would like to request feedback on this, if anyone can confirm or deny my understanding of the coding.

Thanks,
Chris Lyon
 
E/M vs Eye code

We use the 1997 Eye Auditing tool for the E/Ms. Eye specific exam. We use both E/M and eye codes for the visits, whichever is more applicable.
 
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