Optometry Coding & Billing Alert

Choose Wisely Between 92082 and 92083 With This Expert Strategy

- Published on Sun, Nov 21, 2004
"With over $60 on the line, don't risk submitting the wrong code or inadequate documentation Even small practices are likely to have a Humphrey visual field analyzer, yet many optometrists don't know the secrets for securing adequate reimbursement for these services - and they even go so far as to put themselves at risk for costly audits due to lack of documentation. Stop Shortchanging Yourself With Intermediate Codes CPT lists three different visual field examinations - and the higher the code, the higher the reimbursement, says Chad Warren, practice manager at Asheville Vision Associates in Asheville, N.C.:

   92081 - Visual field examination, unilateral or bilateral, with interpretation and  report; limited examination (e.g., tangent screen, Autoplot, arc perimeter or single   stimulus level automated test, such as Octopus 3 or 7 equivalent)
   92082 - ... intermediate examination (e.g., at least 2 isopters on Goldmann   perimeter, or semiquantitative, automated suprathreshold screening program,   Humphrey suprathreshold automatic diagnostic test, Octopus program 33)
   92083 - ... extended examination (e.g., Goldmann visual fields with at least 3   isopters plotted and static determination within the central 30 degrees, or quantitative, automated threshold perimetry, Octopus program G-1, 32 or 42, Humphrey   visual field analyzer full threshold programs 30-2, 24-2 or 30/60-2). Pitfall: A common mistake optometrists make is billing 92082 when they could legitimately bill 92083, says Charles T. Wimbish, OD, president of the Wimbish Consulting Group in Martinsville, Va. He recalls working with one practice that habitually undercoded, potentially missing out on hundreds of dollars of reimbursement. They had coded every visual field at an intermediate level" " he says "when all of them were extended."

The key to choosing the correct VF code is in the code descriptors themselves. For example if you plot only two isopters on the Goldmann perimeter CPT would call that "intermediate " based on its description of 92082. If you plotted three isopters however that would be an "extended" examination that would qualify for 92083.

"Most optometrists don't bill 92081 and 92082 nearly as often as 92083 " says David Gibson OD FAAO practicing optometrist in Lubbock Texas. "In my office most visual fields are ordered due to suspected or known glaucoma. The standard field in glaucoma detection and treatment is a full threshold field 92083."

Rule of thumb: An intermediate test is one of the screening tests that you would use if you suspect neurological damage Gibson says. But optometrists use the threshold exam (92083) when they suspect something that causes a slow progressive dimming of peripheral vision like glaucoma.

"Glaucoma causes a loss of vision like a light bulb slowly becoming dimmer and dimmer " Gibson says "while trauma often causes sudden complete loss of central or peripheral vision." In screening fields [...]

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