Ophthalmology and Optometry Coding Alert

Question: Can CPT code 92060 be billed to Medicare as a separate procedure when an office visit is being billed on the same visit? If yes, does it require a separate modifier or separate diagnosis than the office visit? Is documentation required?

Colleen Caracappa
Coastal Eye Center
Stuart, FL

Answer: Sensorimotor evaluation (92060), found in the Medicine Section of CPT, is one of the three codes that used to be bundled with the eye exam codes (92002, 92012, 92004 and 92014). Last summer (1999), however, Medicare unbundled these codes, meaning you can bill them at the same visit as the eye exam codes.

Note: See the CCI ALERT! insert that accompanied the June 1999 issue of Ophthalmology Coding Alert. If youd like an additional copy, call 800-508-2582.

The other two unbundled codes are gonioscopy (92020) and serial tonometry (92100).

You do not need a modifier when a medicine section code is billed with either an eye examination code or an evaluation and management code. No special documentation is required.