Ophthalmology and Optometry Coding Alert

You Be the Coder:

IOL Master versus A-Scan

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.

Question: The new code 92136 for the intraocular lens (IOL) master pays less than the A-scan code 76519. Do we have to use the new code if we use the IOL master, or can we use 76519 since they are basically for the same thing?

New York Subscriber

 
Answer: Use 92136 for the IOL master, not the regular A-scan code (76519, Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens power calculation). The work involved in 92136 (Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation) is less than the work involved in an A-scan. When a code exists for a procedure, using a different code is considered a misrepresentation of the service, and, if done repeatedly, is a pattern of fraud.