CPT codes for ophthalmology reimburse doctors for services rendered by these specialists. An ophthalmologist is a medical specialist who focuses on the eyes and visual system, performing surgeries and providing medical care for a wide range of eye-related diseases.
Medical billing is an essential part of the ophthalmology field, just as it is in every other area of medicine. Two distinct sets of codes—E&M and eye codes—are needed for ophthalmology medical billing.
In addition to this, medical billing for ophthalmology requires an in-depth understanding of the following subspecialties, which are as follows:
- Pediatric
- Eye plastics
- Retina
- Glaucoma
Since ophthalmology uses two separate code sets, accurate medical billing and coding can be challenging. That’s why ophthalmology practices must have efficient and accurate medical billing systems to boost their revenue cycle.
Reporting the health treatment rendered by ophthalmologists requires using CPT codes specific to the field of ophthalmology. The codes are in the National Correct Coding Initiative (NCCI) manual, published yearly by the Centers for Medicare & Medicaid Services (CMS).
CPT Codes for Ophthalmology Procedures
- 92310: The physician handles prescribing and fitting contact lenses for both eyes, except when the patient has aphakia due to removing the eye’s lens.
- 92311: The doctor prescribes and inserts a corrective lens in one of the patient’s aphakic (cataract-free) eyes.
- 92313: Contact lens prescriptions should include the lenses’ optical properties, which improve the patient’s vision and size and shape, which help them fit appropriately in the eyes.
Also given are guidelines for adjusting the new lenses.
- 92316: The physician recommends corneal contact lenses for both eyes of an aphakia patient. He controls the independent technician’s lens-fitting process.
- 92340-92371: Optical Services (Including Prosthetics for Aphakia):
- 92352: A procedure in which patients who have had cataract surgery and had their natural crystalline lens removed are fitted with spectacles with a single designated focal length.
- 92354: A magnifying lens is attached to the spectacles to enhance the patient’s close vision for activities such as reading.
- 92370: When a patient doesn’t have aphakia or no lens in the eye, the provider adjusts or fixes their eyeglasses.
- 92499-92499: Additional ophthalmological treatments or services
- 92499: Not-specifically-coded ophthalmological procedures.
- 92012 – Complete eye examination: This code denotes a regular eye test that involves an assessment of the patient’s eyesight, refractive error, ocular movement, and binocular vision. In addition, a dilated fundus examination may be performed to look for evidence of illness or abnormalities.
- 66982: Surgically removing extracapsular cataracts and inserting an intraocular lens prosthetic.
- 66984: Endoscopic laser extraction of extracapsular cataracts and implantation of intraocular lens prostheses
- 67101: Cryotherapy or diathermy for retinal detachment repair, with or without subretinal fluid drainage
- 67210: Photocoagulation: a single- or multiple-session procedure for the destruction of a localized retinal lesion (such as macular edema or tumors).
- 92133 – Diagnostic Imaging Using Optical Coherence Tomography: An OCT imaging examination of the retina is designated with the CPT code 92133. OCT is a noninvasive technique that produces high-resolution retinal pictures using light waves.
- 65778 – Crosslinking of Corneal Collagen: As described by the CPT code 65778, corneal collagen crosslinking is used to treat keratoconus, a disorder characterized by the bulging and thinning of the cornea.
- 92020 – Gonioscopy: Gonioscopy is a diagnostic test that looks at the angle of the eye’s anterior chamber. It is described by the CPT code 92020. Usually, glaucoma patients are evaluated using this method.
- 92235 – Angiography with fluorescein: Fluorescein angiography, a diagnostic procedure that uses a dye and a specialized camera to inspect the blood vessels in the retina, is designated by the CPT code 92235.
- 67028 – injection intravitreal: Intravitreal injections entail injecting medication into the vitreous, a gel-like fluid that fills the eye’s posterior chamber. Usually, this surgery is used to cure diseases, including diabetic retinopathy and age-related macular degeneration.
Conclusion
For correct documentation and reimbursement, it’s necessary to be familiar with the most frequently used CPT codes in ophthalmology. Eye examinations, surgical operations, and diagnostic tests are among the most commonly utilized CPT codes in ophthalmology.