Ophthalmology and Optometry Coding Alert

Question: What is the best CPT code to use for forced ductions?

Lynn C. Day, Office Manager
Steven A. Gross, MD, St. Petersburg, FL

Answer: You should use 92018 (ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete). If you do a complete examination, according to Carrie Hass, accounts receivable manager for Eye Health Northwest, a 20 ophthalmologist, four-optometrist practice in Milwaukie, OR. Our doctors have done forced ductions in the past, says Hass. They recommend using 92018, since it is an exam under anesthesia. Duction refers to the movement ability of one eye as measured independently from the other eye. Forced ductions are done under anesthesia. While 92018 does not require manipulation of the globe, it does require general anesthesia. If you were to do only a limited examination under general anesthesia, you would use 92019 (special ophthalmological services, limited).