Optometry Coding & Billing Alert

Question: I have a patient I-m following for glaucoma. I-ve asked him to come back four times on subsequent days, at a different time each day, so I can check his IOL pressure with serial tonometry. How should I bill these visits?


Kansas Subscriber


Answer: When you perform several tonometry tests, you do not have to perform them all on the same day. But you can only report 92100 (Serial tonometry [separate procedure] with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day [e.g., diurnal curve or medical treatment of acute elevation of intraocular pressure]) once, no matter how many times you perform it over several days.

However, if you perform other services during those office visits that meet the requirements of an E/M or eye code, you can report each of those.

Don't miss: Only report one unit of service for 92100 regardless of whether you test one or both eyes. Do not code the test bilaterally with modifier 50 (Bilateral service) appended, because Medicare has judged that modifier inappropriate for this code.

It is inappropriate to bill for 92100 simply because tonometry is performed more than once during an exam. Payment for routine measurements of IOP is included in the allowance for general ophthalmologic services or E/M services, and this applies even if the IOP measurement is repeated during the exam.