Ophthalmology and Optometry Coding Alert

Question: Our ophthalmologist treated an acute glaucoma patient and performed serial tonometry followed by bilateral pachymetry. Which codes should we report to use the multiple tonometry and pachymetry units?

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Answer: When the ophthalmologist is treating acute glaucoma, you can bill for serial tonometry if the ophthalmologist checks the intraocular pressure (IOP) more than three times in the same session. Report 92100 (Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day [eg, diurnal curve or medical treatment of acute elevation of intraocular pressure]) for that service. You don’t need to report multiple units of this code, since it refers to “multiple measurements.”

Ophthalmologists also often use pachymetry for glaucoma patients to determine the correlation between corneal thickness and IOP. CPT^® code 76514 (Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral [determination of corneal thickness]) is inherently bilateral; report it only once whether one or both eyes are tested.

There are no Correct Coding Initiative (CCI) edits that prevent you from reporting 92100 and 76514 together, so if your physician performs both services on the same date, you should bill both codes.