Pediatric Coding Alert

Question: I'm questioning our practice's use of 92015 for photoscreening. The procedure doesn't seem to fit unto 92015 or 99173.


Florida Subscriber

Answer: The codes you mention (92015, Determination of refractive state; and 99173, Screening test of visual acuity, quantitative, bilateral) do not represent photoscreening. To more accurately describe photo-screening, CPT originally created 0065T (Ocular photoscreening, with interpretation and report, bilateral). 

CPT 2008 upgraded 0065T from a Category III (temporary) to a Category I code and gave it a new number: 99174 (Ocular photoscreening with interpretation and report, bilateral). "It was not, unfortunately, assigned an RVU value," says Robert W. Hered, MD, chief of the ophthalmology division at Nemours Children's Clinic in Jacksonville, Fla.

Code 99174 involves using a photoscreening device to screen for esotropia, exotropia, anisometropia, cataracts, ptosis, hyperopia and myopia.

CPT Changes 2008--An Insider's View offers the following clinical example: At an 18-month-old preventive medicine service, the mother mentions that there is a strong history of strabismus and amblyopia. "Clinical examination with typical office instrumentations revealed no abnormality. The pediatrician recommends the child be screened with a photoscreening device." The procedure involves positioning the infant for the photoscreening device and obtaining an image, which is transmitted to a screening lab for quality-controlled interpretation. "Conditions detected include esotropia, exotropia, anisometropia, cataracts, ptosis, hyperopia and myopia."