Ophthalmology and Optometry Coding Alert

Question: Would you please tell me which procedure code I should use when billing for topography? The doctor recently purchased an OPD-Scan and is now performing this test on his patients.

Massachusetts Subscriber b There is no specific CPT code for corneal topography. To report the procedure, use 92499 (Unlisted ophthalmological service or procedure). Make sure that you have "corneal topography" typed into the comments area or Box 19 on your claim form and send a description with the claim.

For non-Medicare payers, you may try using HCPCS code S0820 (Computerized corneal topography, unilateral) for this procedure. Just keep in mind that all payers are not required to recognize HCPCS codes, and there is a plan eventually to phase out the use of HCPCS codes. Make sure you use the appropriate ICD-9 codes to get paid when billing topography. Diagnosis codes that many carriers have found to support medical necessity include:

   367.21 - Regular astigmatism (Report V45.61 [States following surgery of eye and adnexa; cataract extraction status] or V45.69 [... other states   following surgery of eye and adnexa] as secondary code.)
   367.22 - Irregular astigmatism (Report V45.61 or  V45.69 as secondary code.)
   370.00-370.07 - Corneal ulcer
   371.00-371.73 - Corneal opacity and other disorders of cornea
   372.40-372.45 - Pterygium
   743.41 - Anomalies of corneal size and shape
   871.0-871.1 - Ocular laceration
   940.2-940.4 - Burn confined to eye and adnexa
   996.51 - Mechanical complications of other specified prosthetic device, implant and graft; due to corneal graft
   V42.5 - Organ or tissue replaced by transplant; cornea (secondary diagnosis)
   V45.61-V45.69 - States following surgery of eye and adnexa (secondary diagnosis).