Ophthalmology and Optometry Coding Alert

Question: Our ophthalmologist performed a corneal topography on each eye during the same session. Which codes and modifiers apply to this encounter? We aren’t sure when, and when not, to use the bilateral modifiers.

Puerto Rico Subscriber

Answer: You should report 92025 (Computerized corneal topography, unilateral or bilateral, with interpretation and report), but you shouldn’t need any modifiers.

Here’s why: The 2021 Medicare Physician Fee Schedule (MPFS) designates 92025 with a “2” as the indicator of whether bilateral services apply to the code. This means the same code applies whether the physician addressed one or both eyes, and no modifier is required. Therefore, you should report this procedure with 92025, but you should not append modifier 50 (Bilateral procedure).

A bilateral indicator of “3” in the MPFS would mean that the code is not subject to the bilateral surgery adjustment and is paid at 100 percent for each side when you report the code with modifier 50 or modifiers LT (Left side) and RT (Right side).