Ophthalmology and Optometry Coding Alert

Medicare and most commercial insurances cover annual glaucoma screenings for high-risk individuals. These include:

• patients with diabetes,

• individuals with a family history of glaucoma,

• Hispanics 65 and older, and

• African-Americans 50 and older.

While these are the groups that the glaucoma screening codes G0117 and G0118 are targeting, most but not all of this group will probably have other ocular complaints or problems that will justify a complete exam which will include all the components of a glaucoma screening exam, notes David Gibson, OD, FAAO, a practicing optometrist in Lubbock, Texas. "This is why the glaucoma screening procedure codes are not used extensively but are handy to have anyway."

Example: The screening codes are not necessary for patients with diabetes, Gibson says. Use a code for  a full exam, and list diagnosis code 250.0x (Diabetes mellitus without mention of complication).