Optometry Coding & Billing Alert

Question: I understand that a visual field screening is 92081, and a 30-2 full-threshold exam is 92083. What test corresponds to the visual field code 92082?


New York Subscriber

Answer: CPT provides several examples in its definition of 92082 (Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination). Visual field exams that meet CPT's definition of 92082 include:

- At least 2 isopters on the Goldmann perimeter
- Semiquantitative, automated suprathreshold screening program
- Humphrey suprathreshold automatic diagnostic test
- Octopus program 33.

In addition, some Medicare Part B carriers have provided lists of alternative terms that meet the criteria for VF tests 92081-92083. Empire Medicare Services, the Part B carrier for New York, lists the following alternative terminology for 92082:

- Octopus program 33 or 34 or equivalent
- Quantity defects strategy (missed points are threshold and depth of defect recorded).

According to Empire, 92081 (- limited examination [e.g., tangent screen, Autoplot, arc perimeter, or single stimulus level automated test, such as Octopus 3 or 7 equivalent]) covers the following alternative terminology:

- Single intensity (seen or not seen) strategy
- Three zone strategy (seen, relative or absolute)
- Threshold related (seen or not seen).

For 92083 (- extended examination [e.g., Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 degrees, or quantitative, automated threshold perimetry, Octopus program G-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2]) Empire includes:

- Full threshold strategy
- Full threshold from prior data strategy
- Central full threshold (or from prior data) and kinetic peripheral strategy.

Note: Optometrists bill less frequently for 92082 than 92083; many problems that you find in the course of 92082 will need to be further investigated with 92083. In these cases, you should only code 92083.