Ophthalmology and Optometry Coding Alert

CPT Codes 2002 creates two important new codes for ophthalmologists: a biometry code for precataract surgery measurements and one for same-day ocular photodynamic therapy treatment in two eyes. The codes go into effect on Jan. 1, 2002. Providers have three months, until March 31, 2002, to use either CPT 2001 or 2002 codes.

New Biometry Code

The new biometry code (92136, ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation) can be used for the IOL Master (Zeiss Humphrey), a new machine that measures corneal curvature without touching the eye. It's used for the same purpose as an A-scan (76519).
 
Oddly, this code is with the ophthalmological-services codes instead of the radiology codes. Originally, the American Academy of Ophthalmology (AAO) had asked for it to follow 76519 (ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation). The code belongs in the radiology section, but the CPT editorial panel placed it with the 92xxx series instead
 
Code 92136 will be valued the same as 76519, says Michael X. Repka, MD, AAO adviser to the AMA CPT advisory committee.

OPT in Second Eye

The add-on code for treating the second eye with OPT on the same day is +67225 (destruction of localized lesion of choroid [e.g., choroidal neovascularization]; photodynamic therapy, second eye, at single session [list separately in addition to code for primary eye treatment]).
 
The code for the primary eye treatment (67221, destruction of localized lesion of choroid [e.g., choroidal neovascularization]; photodynamic therapy [includes intravenous infusion]) includes the infusion, but not the Visudyne, the medication that must be injected to proceed with phototherapy.
 
Since only one IV injection is needed to treat both eyes at the same session, the add-on code does not include the fee for the second infusion.
 
Code +67225 is valued with the expectation that it will be used with 67221; modifiers -50 (bilateral procedure) and -51 (multiple procedures) do not apply to add-on codes.

Modifiers

Modifier -60 (altered surgical field) has been deleted. Ophthalmologists who perform a procedure that requires extra work due to an altered surgical field, such as scar tissue from previous surgery, must use modifier -22 (unusual procedural services).