Ophthalmology and Optometry Coding Alert

Reader Question:

Corneal Topography

Question: Is there a diagnosis code that Medicare is looking for specifically for reimbursement of corneal topography? They used to pay with a V-code only. Now it seems they will reject V-codes one time and pay another. We only bill this for patients that have either had PK, or are going to have PK.

Bay Eye Associates, Traverse City, Mich.

Answer: Most Medicare carriers will not pay for corneal topography, which is an unlisted code (92499) to begin with, unless the service is performed for surgically induced astigmatism. There is no specific diagnosis code for surgically induced astigmatism; to indicate this you use 367.21 for regular astigmatism or 367.22 for irregular astigmatism, followed by V45.6 for condition following surgery, or V42.5 for corneal transplant. Each carrier has different rules for how to file for unlisted procedure codes.

But in most [...]
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