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92012 vs 99213

Samantha Posted Mon 02nd of March, 2020 13:35:47 PM
Supercoder states for CPT 92012- initiation or continuation of diagnostic and treatment program; intermediate, established patient. Would billing 92012 require a new problem or just a continuation of the treatment already established, IE- eye drop therapy?
SuperCoder Answered Tue 03rd of March, 2020 04:13:42 AM

Hi Samantha,


Intermediate ophthalmological service CPT code 92012 describes an evaluation of a new or existing condition complicated with an acute problem that may not be related to the primary diagnosis including the review of previous history, a general examination, a few diagnostic procedures.


The main difference between 92012 and 92014 is that 92014 is for comprehensive evaluation which includes dilation unless medically contraindicated.


A comprehensive exam (92014 for an established patient or 92004 for a new patient) also includes more exam components than an intermediate exam (92012 for an established patient or 92002 for a new patient).



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