Ophthalmology and Optometry Coding Alert

Answer: Medicare and many other carriers consider Schirmer’s tests to be included in the evaluation and management (E/M) service rendered, so you shouldn’t report the test separately. CPT^® does not include a code for this procedure — Schirmer’s test is one of many diagnostic services that cannot be coded separately from an E/M code or eye code.

One option: You can try using 92499 (Unlisted ophthalmological service or procedure) for non-Medicare insurers, but many will not reimburse for the service.

Caution: You might be tempted to use 95060 (Ophthalmic mucous membrane tests). But you should only use this test code, listed in CPT^®’s allergy testing section, for mucous membrane testing; you should not report it for Schirmer’s tear testing.

Bad news: There’s also no HCPCS Level II code for Schirmer’s test materials. You can try 99070 (Supplies and materials (except spectacles), provided by the physician … over and above those usually included with the office …), but you’ll need to document the price of the supplies by sending in the invoice. Although, the supplies cost may not be worth the time and expense of sending this documentation.