Ophthalmology and Optometry Coding Alert

Question: Is there a CPT code for exophthalmometry?

Georgia Subscriber

Answer: CPT considers exophthalmometry - a test to measure proptosis, using a Hertel exophthalmometer - to be an integral part of the evaluation and management service; therefore, it is not reimbursed separately and no CPT code exists for separate billing of this service. If you're using the eye codes rather than E/M codes, it is considered included in an intermediate eye exam.

When you bill an office visit to Medicare, the test is included in the total service rendered that day. When billing insurances other than Medicare, you can attempt to bill using 92499 (Unlisted ophthalmological service or procedure), but it is doubtful you will receive additional reimbursement for the test because your only documentation will be a written reading.