Ophthalmology and Optometry Coding Alert
Associated Diagnoses
Medicare covers IOL calculation procedures for patients about to undergo cataract surgery. But just listing 366.x (Cataract) as your diagnosis code is likely to get your claim rejected.
Below is a list of specific ICD-9 codes that most carriers recognize as demonstrating medical necessity for both 76519 (Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation) and 92136 (Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation):
Be sure to check with your own local carrier for specific coverage rules.
Ophthalmology and Optometry Coding Alert
- Pre-Cataract Surgery Tests:
76519, 92136: Understand Bilateral Rules and Receive Fair Reimbursement
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Post-Op Exam With Unrelated Complaint
Question: We did a general eye exam at the patient’s request within the three-month period [...] - Reader Question:
Angle Kappa Measurement Is Incidental
Question: We perform a measurement called angle kappa to help in calculating and choosing a [...] - Reader Question:
76514 Suffices for Bilateral Pachymetry
Question: I’m trying to submit a claim for 76514 performed on both eyes, but I’ve [...] - Reader Question:
379.31 Proves Necessity for V2219
Question: I’m really confused about codes V2219 and V2319 for Medicare patients. I know it’s [...]
