Optometry Coding & Billing Alert

Question: I have a question about coding my contact lens fittings. The two code sets for the service, 92310-92313 and 92314-92317, seem almost identical to me.

Missouri Subscriber

Answer: Your code choice will depend on who performs the procedure.

If the optometrist or another qualified physician performs the fitting, choose from 92310-92313, depending on the situation.

Suppose an optometrist fits both of a patient's eyes with corneal lenses. On the claim, you-d report 92310 (Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia) for the service.

If an independent technician performs the fitting in the optometrist's office, choose from 92314-92317, depending on the situation.

Suppose a technician fits both of a patient's eyes with corneal lenses. On the claim, you-d report 92314 (Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes, except for aphakia) for the service.

Report 92310-92313 only if the ophthalmologist or another physician in your office--- not an independent technician--- is doing the contact lens fitting as well as supervising the adaptation.

If you-re writing the prescription for the lenses but an independent contractor technician in your office does the actual fitting, report 92315 (Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, one eye), 92316 (... corneal lens for aphakia, both eyes) or 92317 (... corneoscleral lens).

-- Answers to You Be the Expert, Reader Questions and Building a Better Business reviewed by David Gibson, OD, FAAO, practicing optometrist in Lubbock, Texas.