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Ophthalmology and Optometry Coding Alert

News Brief:

Medicare Will Cover Glaucoma Screening for High-Risk Patients

Published on Sat Dec 01, 2001

As of Jan.1, 2002, Medicare will cover an annual glaucoma screening for high-risk patients such as those with a family history of glaucoma or a personal history of diabetes.
 
Medicare previously covered glaucoma screening only for patients who had signs or symptoms of the disease. Under the new regulations, Medicare will cover an annual dilated eye exam with intraocular pressure measurement, and direct ophthalmoscopy or slit-lamp biomicroscopic exam if there is reason to believe the patient has high risk of glaucoma, even though the patient may have no signs, symptoms or previous suspicious exam findings.
 
Code glaucoma screening with one of two codes:
 
G0117 glaucoma screening for high-risk patients furnished by an optometrist or an ophthalmologist
 
G0118 glaucoma screening for high-risk patients furnished under the direct supervision of an optometrist or an ophthalmologist.  
Bill these examinations with V80.1 (special screening for neurological, eye, and ear diseases; glaucoma).
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