Ophthalmology and Optometry Coding Alert

Reader Questions:

Modify Eye Codes Just Like E/M Codes

Question: I just started working in an ophthalmologist's office and I have a question about modifiers. Can we append modifiers 25 or 57 to the eye codes 92002-92014? The descriptions of the modifiers only specify E/M codes -- do the eye codes count? Arizona SubscriberAnswer: Medicare and most other carriers treat the eye codes -- 92002 (Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient), 92004 (... comprehensive, new patient, one or more visits), 92012 (Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient) and 92014 (... comprehensive, established patient, one or more visits) -- the same as E/M codes.Therefore, if there is a separately identifiable service, you can report it with an eye code or an E/M code and append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same [...]
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