Ophthalmology and Optometry Coding Alert

Question: A patient who has had LASIK surgery now has cataracts. One of our ophthalmologists performed topography to calculate the IOL power. The cataract diagnosis (366.16) is not listed as a covered code for that diagnostic service. Which diagnosis code should we use for the topography?

Texas Subscriber

Answer: Some payers accept V45.69 (Other states following surgery of eye and adnexa), indicating previous LASIK surgery, as a covered diagnosis for corneal topography. However, some payers, such as Cigna, specify that V45.69 must be accompanied by diagnosis code 367.22 (Irregular astigmatism). Check with your payer to see if it has such limitations.

Corneal topography is an alternative method for determining IOL power in cases in which previous LASIK surgery makes it difficult to use an A-scan or IOL Master. Report 92025 (Computerized corneal topography, unilateral or bilateral, with interpretation and report) for the test.