Ophthalmology and Optometry Coding Alert

Question: How often can a gonioscopy test be performed on a patient?

New Jersey Subscriber

Answer: The frequency of gonioscopy examinations carried out on glaucoma suspect patients largely depends on medical necessity to justify such tests. The allowed frequency of testing that may be performed and filed for reimbursement is a common concern expressed by physicians. The American Optometric Association recommends an annual dilated eye examination for people at risk for glaucoma as a preventive eye care measure.

Depending on your specific condition, your doctor may recommend more frequent examinations. Gonioscopy may need to be repeated periodically and/or every one to five years.

A follow-up test is necessary upon evidence of new symptoms, progressive disease, new findings, unreliable prior results, or a change in treatment plan. As a rule, an additional testing is justified when the information garnered from the eye examination is not adequate to assess the patient's disease process completely.

Watch out for: If a patient has a history of glaucoma and the ocular examination reveals an unstable or worsening condition, then more extensive testing may be justified. A patient with a stable visual field test is less likely to require additional testing than someone with an uncontrolled condition.

-- Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, consulting manager for Pershing, Yoakley, and Associates in Clearwater, Fla.