92020, Gonioscopy = Gonioscopy is a technique for examining the visually inaccessible anterior chamber angle, the drainage apparatus of the eye - the trabecular meshwork, and its anatomical relation to the adjacent iris. It represents a "bilateral" procedure.
Evaluation of glaucoma (narrowness or closure of the anterior chamber angle, historical evidence of angle closure)
Evaluation of growth or tumor in the angle
Evaluation of suspected neovascularization of the angle.
Evaluation of uveitis.
Evaluation of conditions affecting the ciliary body.
Evaluation of degenerative conditions affecting the anterior segment
History or signs of penetrating ocular foreign body
Assess peripheral anterior synecchiae (PAS)
Evaluation after trauma for angle recession
DX Codes that support Medical Necessity MUST be linked to procedure.
92225, 92250 - Helpful Link
92225, Initial Bilateral/92226, LT/RT = Definition:
Examination of the interior of the eye, including the lens, retina and optic nerve, by indirect or direct ophthalmoscopy. Indirect ophthalmoscopy employs a head lamp device to shine a very bright light into the eye. This is generally done by an ophthalmologist.
92250 = Definition:
Fundus photography with interpretation and report to document a disease process or follow the progress of a disease, photographs may be necessary. Photographs may also be necessary to plan treatment for a disease process.
Again, ICD9 MUST support the use of procedure, frequency.
All of these services are appropriate means of diagnosing, establishing treatment plan, etc. I think that it would be appropriate to bill out these other services with a consult (with modifier when done w/ gonio), if documentation supports the medical necessity, are "separately identifiable", etc.
Hope this helps you & Good Luck!
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