Ophthalmology and Optometry Coding Alert

Question: We cannot figure out which code we should bill when we perform a glaucoma screening. We typically report G0117 and G0118 but it’s unclear why we can’t always collect for these services.

Washington, D.C. Subscriber

Answer: You’ll report the appropriate code depending on who performs the screening, either G0117 (Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist) if the doctor does the screening or G0118 (Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist) if it’s under the direct supervision of the doctor.

There are practices that assume that they should list both codes on their claims. However, this constitutes incorrect coding. Instead, you should read the documentation to see who performed the service and then select the right code depending on which practitioner provided the service.

As for your diagnosis code, you’ll report the ICD-10 code Z13.5 (Encounter for screening for eye and ear disorders) for asymptomatic patients who are getting screened for glaucoma.