Ophthalmology and Optometry Coding Alert

Let form and severity drive your coding choice. With 18 plus options to sift through when coding a glaucoma visit, you need these simple guidelines to secure the insurer preferred code that lands payment, not denial. You have four options for coding glaucoma exams, depending on the form and severity of the glaucoma. You are given a choice of using four ophthalmic visit or CPT codes (or "eye codes") (92002-92014, Ophthalmological services: medical examination and evaluation ...), 10 evaluation and management (E/M) codes (99201-99215, Office or other outpatient visit ...), two HCPCS S codes (S0620 and S0621, Routine ophthalmological examination including refraction ...), two G codes (G0117 and G0118, Glaucoma screening for high risk patient ...), or, possibly, a combination of these. Hidden trap: You cannot use any combination of these on the same day, warns David Gibson, OD, FAAO, a practicing optometrist in Lubbock, Texas. "In coding any patient/physician [...]