Wiki Proper usage of ICD with 92002-92014

[ngou719]

Hello all,
I'm fairly new to the "vision coding" and would like to get some insight as to the DX usage for the 920XX codes. Also does this code set get paid by Medicare? If so, what DX is needed for it? Another question to this code set is... When would it be appropriate to use them? Would you be able to give me some good recourse links to your guidance? TIA!!!!

 

[Hkaushik]

Yes, this was paid by Medicare and we need to send this with refractive error DX code

 

[Cheezum51]

Yes, this was paid by Medicare and we need to send this with refractive error DX code

If you bill the 920xx codes with a refractive error ICD code, the exam WILL NOT be paid by Medicare or any other carrier. Those codes are only billed with a disease code such as cataract, allergic conjunctivitis etc in order to be paid. The refractive diagnosis codes should only be billed with the 92015 refraction code, which Medicare and most other carriers DO NOT cover.

 

[ngou719]

If you bill the 920xx codes with a refractive error ICD code, the exam WILL NOT be paid by Medicare or any other carrier. Those codes are only billed with a disease code such as cataract, allergic conjunctivitis etc in order to be paid. The refractive diagnosis codes should only be billed with the 92015 refraction code, which Medicare and most other carriers DO NOT cover.

Thank you! Would you have some resource links you can share? Something as to when to use E/M or eye visit codes. Can you tell me when it's appropriate to use the Z01.XX DX?