Ophthalmology and Optometry Coding Alert

Prove VF Necessity With Accurate ICD-9 Coding

Although your individual insurer may have its own rules for payment, here is a list of diagnoses that many Medicare carriers agree may support medical necessity for CPT codes 92081-92083 (Visual field examination, unilateral or bilateral, with interpretation and report ...):

  • 191.0-191.9 -- Malignant neoplasm of brain
  • 192.0 -- Malignant neoplasm of cranial nerves
  • 194.3 -- Malignant neoplasm of pituitary gland and craniopharyngeal duct
  • 198.89 -- Secondary malignant neoplasm of other specified sites
  • 224.5 -- enign neoplasm of retina
  • 225.1 -- Benign neoplasm of cranial nerves
  • 227.3 -- Benign neoplasm of pituitary gland and craniopharyngeal duct
  • 234.8 -- Carcinoma in situ of other specified sites
  • 237.0 -- Neoplasm of uncertain behavior of pituitary gland and craniopharyngeal duct
  • 239.6 -- Neoplasm of unspecified nature of brain
  • 239.7 -- Neoplasm of unspecified nature of endocrine glands and other parts of nervous system
  • 348.2 -- Benign intracranial hypertension
  • 362.11-362.18 -- Other background retinopathy and retinal vascular changes
  • 364.22 -- Glaucomatocyclitic crises
  • 365.00-365.82 -- Glaucoma
  • 368.40-368.47 -- Visual field defects
  • 377.00-377.04 -- Papilledema
  • 377.14 -- Glaucomatous atrophy (cupping) of optic disc
  • 377.15 -- Partial optic atrophy
  • 377.30-377.34 -- Optic neuritis
  • 377.41 -- Ischemic optic neuropathy
  • 377.42-- Hemorrhage in optic nerve sheaths
  • 377.49 -- Other disorders of optic nerve
  • 379.21 -- Vitreous degeneration
  • 784.0 -- Headache
  • V58.63-V58.69 -- Long-term (current) drug use
  • V67.51 -- Follow-up examination following completed treatment with high-risk medication not elsewhereclassified.

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