Optometry Coding & Billing Alert

Question: Our doctor saw a patient for droopy eyelids, and to determine the extent to which her droopy eyelids interfered with her vision, he performed two bilateral visual field tests on the same day (Humphrey full-field 120 point). The doctor performed the first field test normally, and the second after taping the patient's eyelids. The diagnosis is dermatochalasis (374.87). How should we code for this procedure? The patient has a commercial insurer that mirrors the Medicare guidelines.

Pennsylvania Subscriber

Answer: Most Medicare carriers want you to report just one code for visual fields, even if an optometrist needs to perform the test twice -- once with lids untaped, once with lids taped -- to confirm that the dermatochalasis is interfering with vision. Optometrists often perform these tests prior to an ophthalmic surgeon performing blepharoplasty procedures to correct the eyelid drooping.

For those carriers, report one unit of the appropriate 92081-92083 code (Visual field examination, unilateral or bilateral, with interpretation and report...). Since the definition states "unilateral or bilateral," report just one unit even when the optometrist examines both eyes.

Try this: One way to reduce the amount of time spent in visual field testing is to create a custom visual field that uses lots of points superiorly and only a few spots below the line of sight.