Part B Insider (Multispecialty) Coding Alert
Reader Question:
92025: Corneal Topography Shouldn't Require Unlisted
Published on Wed Jun 15, 2011
Question:
Answer:
For corneal topography, report 92025 (Computerized corneal topography, unilateral or bilateral, with interpretation and report). You do not need to resort to 92499 (Unlisted ophthalmological service or procedure). Check with your carriers for their rules on demonstrating medical necessity for this procedure. For example, Medicare Part B carrier Cigna has published a local coverage determination (LCD) listing these diagnoses for which 92025 would be medically necessary:- 367.22 -- Irregular astigmatism
- 371.00 -- Corneal opacity, unspecified
- 371.23 -- Bullous keratopathy
- 371.50 -- Corneal dystrophy, unspecified
- 371.52 -- Other anterior corneal dystrophies
- 371.57 -- Endothelial corneal dystrophy
- 371.60-371.62 -- Keratoconus
- 372.40 -- Pterygium, unspecified
- 996.51 -- Mechanical complication of other specified prosthetic device, implant, and graft; due to corneal graft
- V42.5 -- Organ or other tissue replaced by transplant; cornea
- V45.61 -- States following surgery of eye and adnexa; cataract extraction status
- V45.69 -- Other states following surgery of eye and adnexa.
Watch for:
Cigna goes on to specify that irregular astigmatism code 367.22 must always be accompanied by V45.61 or V45.69. The reverse is also true: V45.61 and V45.69 must always appear with 367.22.ABN alert:
Some carriers may still find corneal topography to be "experimental or investigational." Consider having patients sign an advance beneficiary notice (ABN) before you perform this procedure. However, keep in mind that it can be very difficult to get a patient to pay for a procedure that their insurance company considers experimental."Other Articles in this issue of
Part B Insider (Multispecialty) Coding Alert
- HIPAA:
Facility Pays $865,500 Fine After Staffers Peeked at Patient Health Records
You don't need celebrity patients to learn from this HIPAA mistake.If you knew Brad Pitt [...] - Your Employees' Facebook Posts Could Come Back To Haunt You
on't risk patients' privacy just to blow off steam.The last thing your practice needs is [...] - Part B Mythbuster:
Buying Equipment? Ensure Medicare Reimbursement First
Don't let manufacturers snow you into investing in new gadgets.A neighboring medical practice raves about [...] - Diagnosis Coding:
Know Your OB-Gyn Diagnoses With This Handy Chart
Plus: Get to know the ICD-10 codes for these conditions.Doctors who treat gynecological conditions don't [...] - Documentation:
Code Charts Properly Every Time by Nailing Down Acronyms
Would you be able to count E/M bullets properly if the physician wrote 'WBC WNL'?Sometimes [...] - Physician Notes:
MRIs Are Now Billable for Patients with Pacemakers, CMS Says
Plus: MACs offer new opportunities to perform 5010 testing.Not all coverage news coming out of [...] - In other news
If you missed the first 5010 form testing day in June, never fear--CMS has not [...] - Reader Question:
92025: Corneal Topography Shouldn't Require Unlisted
Question: What are the rules are for coding corneal topography? I can't find a CPT® [...] - Reader Question:
Avoid Outdated Diagnoses
Question: Our practice recently saw a patient who had been having intractable seizures. The patient [...] - Reader Question:
'MIP' and 'MEP' Require Unlisted Diagnoses
Question: How should I bill MIPs (maximum inspiratory pressures) or MEPs (maximum expiratory pressures)? My [...] - Reader Question:
Only Hawaii Requires Coding Certification
Question: I attended a conference recently and a speaker said that CMS is or will [...] - Reader Question:
Consider Shaving, Photo Documentation Integral Parts of EGD
Question: My gastroenterologist wants me to bill photo documentation along with an EGD. Can I [...]
View All
