Ophthalmology and Optometry Coding Alert

You Be the Coder:

Pachymetry

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

Question: What is the correct code for pachymetry?

Wisconsin Subscriber

Answer: The only correct code for pachymetry, which measures corneal thickness, is 92499 (unlisted ophthalmological service or procedure). Use 92499 for corneal pachymetry with a private payer only.

Medicare doesn't view pachymetry as a separately billable service. Although it is not normally done with every exam, Medicare does not consider it significant enough to bill separately from an E/M service or an eye exam. Medicare places pachymetry in the same category with potential acuity meter (PAM) and Schirmer tear testing.

Some coders try to bill pachymetry with 76516 (ophthalmic biometry by ultrasound echography, A-scan) or with 92070 (fitting of contact lens for treatment of disease, including supply of lens). Each of those options is incorrect.