Optometry Coding & Billing Alert

Question: I'm having trouble finding a CPT code for a Schirmer's tear test. How can I bill for it?


Florida Subscriber


Answer: Include the cost of the Schirmer's test in an eye exam or E/M code. There is no specific CPT code for the Schirmer's tear test, a fact that has vexed optometrists for some time. Also vexing is the fact that most insurers (including Medicare carriers) will not pay separately for the test. They consider the test, in which the optometrist inserts small slips of paper into the conjunctiva to measure tear production, an integral part of a routine eye exam.

What about supplies? There's no HCPCS code for the Schirmer's test materials. You can try billing with 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) - but to do that, you need to document the price of the supplies by sending in the invoice.

The cost of the postage (not to mention your time in putting the claim together) will probably be more than the cost of the Schirmer's strips.