Ophthalmology and Optometry Coding Alert

Question: We tend to use 92082 to avoid overcoding. When a patient undergoes visual field (VF) testing, how many isopters need to be plotted on the Goldman perimeter to be able to report CPT^® code 92083?

Alabama Subscriber

Answer: A common mistake ophthalmologists make is billing 92082 (Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on Goldmann perimeter …) when they could legitimately report 92083 (… extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30° …).

The key to choosing the correct VF code is in the code descriptors themselves. For example, if the eye care specialist performs an exam that uses at least two isopters for testing via the Goldmann perimeter method, CPT® would call that “intermediate,” based on its description of 92082. If three isopters are plotted, however, that would be an “extended” examination, which would qualify for 92083.

Rule of thumb: An intermediate test is one of the screening tests that physicians would use if they suspected neurological damage. However, ophthalmologists use the threshold exam (92083) when they suspect something that causes a slow, progressive dimming of peripheral vision, such as glaucoma.

Providers should always document medical necessity for the level of visual field testing that is ordered. It’s never appropriate to plot additional isopters just to boost your code level.