Wiki Billing 92283 Color Vision Examination, Extended

[hstockhecker@yahoo.com]

Hello,
I was wondering if anyone has any experience billing 92283: Color Vision Examination, Extended. I work for an optometry practice and the doctors are considering the purchase of a new testing machine, but want to know if insurances will pay for the procedure before making the investment. The tricky part is there's not really a way to do the procedure without the technology to be able to know ahead of time. I have attempted to research the code with various insurances, both by looking for payment policies and reaching out to our provider relations representatives, and have not found much specific information. Searching CMS does not turn up any NCDs or LCDs (we're located in Rhode Island, so our MAC is NGS).

Has anyone billed this code and had it pay? My doctors are specifically interested in if it pays when paired with diagnoses of Diabetes, Glaucoma, and Age Related Macular Degeneration.

Any insight would be appreciated!

 

[Cheezum51]

Looking at the description for this test, I wonder how often you would really need to do this extended color vision exam. It is a covered test with our Medicare carrier, Palmetto, and pays $55.16. It requires doctor orders and a full Interpretation and Report with doctor signature. A Corcoran paper I found on this testing says it has a frequency of about 1% of patients, based upon Medicare claims filed. The article also suggests that the patients be given and sign an ABN.

Personally, as an OD who saw lots of pathology in my practice, I don't know what value this test would have. We know that any patient with a macular problem is most likely going to have some color vision defect as well. Does that defect tell us as much as an OCT of that part of the retina. I would seriously doubt it, but that's my opinion.

If the Medicare filing rate is about 1%, if you have 6000 patients seen per year for comprehensive exams in large practice, that's 60 patients per year if your testing level falls within the 1% range of Medicare testing. So that's about $3300 in fees per year. Worth it? Not sure. I guess it depends on how much it costs.

I had several sales reps try to sell me various equipment through my 43 years in active practice based upon their calculations of profit and use etc. In most cases, it didn't pan out as they projected.

I know this isn't what you asked but it's what came to mind when I saw you question.

Tom Cheezum, OD, CPC, COPC