Issue link: https://optometricmanagementsupplements.epubxp.com/i/587112
S P E C I A L E D I T I O N 2 0 1 5 • O P T O M E T R I C M A N A G E M E N T . C O M 51 T HERE HAS been signifcant advancement in technology related to the anterior seg- ment of the eye. Technolo- gies that help you ft contact lenses on corneas that were previously unfttable and diagnose ocu- lar surface disease in individuals whose anatomical structure weren't easily vis- ible to the average clinician are now read- ily available. Ofen, O.D.s struggle when determining the proper codes to describe these new technologies; however, all it takes is an understanding of the current codes and their appropriate defnitions and applications. WHAT CODES DO I USE? In most cases, newer technologies that allow to you examine the cornea in greater detail or to visualize ana- tomical structures, such as the mei- bomian glands, are best described with existing CPT codes you are very familiar with: • 92285 - External ocular photogra- phy with interpretation and report for documentation of medical prog- ress (e.g., close-up photography, slit lamp photography, goniophotography, stereo-photography) • 92286 - Special anterior segment photography with interpretation and report; with specular endothelial mi- croscopy and cell count • 92025 - Computerized corneal top- ography, unilateral or bilateral, with interpretation and report • 92132 - Scanning computerized ophthalmic diagnostic imaging, ante- rior segment, with interpretation and report, unilateral or bilateral Ofen, new technology will not have a CPT code, but instead will be assigned a HCPCS Level III code, which is the appropriate classifcation for new technologies (more on this be- low). Examples include: • O33T - Tear flm imaging, unilateral or bilateral, with interpretation and re- port (i.e., LipiView) • 0270T - Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral (i.e., LipiFlow) COMMON MISCONCEPTIONS Tat said, there are many mis- conceptions about what can be coded and billed. For example, let's examine a multipurpose diagnos- tic instrument that performs many functions, including: • Corneal topography (CPT 92025) • Anterior segment photography (CPT 92285) • Zernike and Fourier analysis of the cornea • Contact lens ftting (CPT 92310 and/or 92072) • Keratometry • Tear meniscus height • Lipid layer thickness • Meibomian gland imaging • Tear flm break-up time • Pupillometry As noted above, there are really only four possible CPT codes that could be generated with this instru- ment. All other tests are considered to be incident to the ofce visit and are not separately describable with a Contact lens coding: Properly coding new technologies that help you ft contact lenses and better assess the ocular surface involves knowing the rules, defnitions and appropriate usage guidelines. CODING NEW TECHNOLOGY THE NEED-TO-KNOW CODING POLICIES SURROUNDING CONTACT LENS WEAR BUSINESS CODING STRATEGIES