Optometry Coding & Billing Alert

Question: We did a visual field at the request of a primary-care physician for a patient who had a stroke. We sent the results of the test to the PCP and submitted a claim for just the technical component, with modifier TC. But then the PCP asked if one of our providers could do the interpretation and send it back to him. Can we report the interpretation if we didn't order the original test?

Washington Subscriber

Answer: Yes. Report the visual field code with modifier 26 (Professional component) appended. The visual field codes -- 92081 (Visual field examination, unilateral or bilateral, with interpretation and report; limited examination), 92082 (... intermediate examination) and 92083 (... extended examination) -- are split into professional and technical components.

Because you coded 9208x with modifier TC (Technical component) appended on your first claim, you should now be able to submit a new claim, using the same code with modifier 26 appended to show that your optometrist interpreted the test.

Another way: Submit a corrected claim of 9208x without any modifiers, replacing the claim for the technical component with a claim for the global service.