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92133 for Glaucoma

Stacey Posted Thu 07th of June, 2012 20:49:59 PM

How often can I bill 92133 with a glaucoma dx of 365.11?

SuperCoder Answered Thu 07th of June, 2012 21:18:21 PM

Optic Nerve
CPT Code: 92133

Common Diagnosis: Glaucoma

365.04
365.11
Modifiers: No modifiers. This code is considered bilateral without modifiers. Modifier 50 will result in rejection by most payers. Code considered unilateral or bilateral.

Use of Modifiers TC/26: Acceptable
.
Coincidental Codes:

Fundus Photo 92250
Ophthalmoscopy 92225/92226
B-Scan 76512
OCT Macular 92134
Frequency:

No more than four times yearly.

Link to Medicare policy on this code

Note that effective 1/1/2011 92135 is no longer a valid code for the vast majority of payers, including Medicare. GDX/OCT must now be specified whether 92132, 92133, or 92134.

Use 92132 for anterior segment, thickness, cornea, sclera

Use 92133 for optic nerve

Use 92134 for macular, retina

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