Ophthalmology and Optometry Coding Alert

Question: Our ophthalmologist renders single-episode tonometry services on her patients, specifically air puff and indentation tonometry. We can’t seem to find the codes for these. 

Michigan Subscriber

Answer: Single-episode tonometry is a component of a general ophthalmological service or E/M service. Therefore, it is not separately billable.

Serial tonometry — CPT® code 92100 (Serial tonometry [separate procedure] with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day [e.g., diurnal curve or medical treatment of acute elevation of intraocular pressure]) — consists of multiple measurements, as the code descriptor indicates. Multiple measurements of intraocular pressure (IOP) are taken over a given time period on a single day in order to monitor response to treatment or document pressure changes throughout the day.

Most Medicare carriers require that the ophthalmologist perform three tests over six or more hours before it can be considered serial tonometry.

Don’t report 92100 just because the ophthalmologist performed tonometry once or twice during an eye exam. Medicare and CPT® both consider tonometry incidental to an intermediate or comprehensive exam for a new or established patient (92004 or 92014) or E/M service (992xx). This is true even if the ophthalmologist repeats the tonometry.

Don’t miss: The ophthalmologist may not perform all of the serial tonometry tests in the same day, but even if he spreads the test out over several days, you can still report 92100 only once. Medicare considers the procedure bilateral, so only code it once whether the physician tests one or both eyes.