Ophthalmology and Optometry Coding Alert

Reader Question:

Unilateral 92133

Question: We performed an OCT on a patient’s left eye, and filed the claim with 92133-LT. Will the payment be reduced because only one eye was done?


Tennessee Subscriber

Answer: The optical coherence tomography test, code 92133 (Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve), is considered bilateral, and payment is for both eyes. The correct modifier to use would be modifier 52 (Reduced services), but most payers will pay the same amount regardless of whether only one eye was tested.