Neurology & Pain Management Coding Alert

Question: How should I code for pupillometry?

Oregon Subscriber

Answer: CPT does not include a code for pupillometry, so coders might have different opinions on how to report the procedure.

Some coders recommend 66762 (Iridioplasty by photocoagulation [one or more sessions] [e.g., for improvement of vision, for widening of anterior chamber angle]), but others say your best option is 92499 (Unlisted ophthalmological service or procedure). Append modifier 50 (Bilateral procedure) if the physician performs the procedure on both eyes.

Include a short narrative with your claim describing the procedure. If you submit 92499, also include documentation of how you determined your pricing.

When you might use it: Pupillometry is not a neurology procedure, so using the code for it in your physician's practice might seem out of place. The procedure could come into play, for example, when physicians are trying to determine whether Behcet's disease impairs autonomic innervation of a patient's pupil.