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Jody Posted 2 Year(s) ago

We perform taped and untaped fields for patients prior to blepharoplasty. We currently bill 92082 twice with the -76 modifier on the second line item. The fields are linked to either a bleph diagnosis or ptosis, depending on the situation. We use a Zeiss Humphrey Visual Field Analyzer (745i). Is this the correct way to bill for the fields?

Some carriers pay both fields with no issues. The local Medicare carrier (Cahaba GBA) will deny both line items with the 92082 procedure code.

Any help you can offer is greatly appreciated.


SuperCoder Posted 2 Year(s) ago

Medicare's fee schedule gives code 92082 a bilateral indicator of "2," meaning that it sees the codes as inherently bilateral. CMS bases the relative value units (RVUs) assigned to 92081–92083 on the assumption that the ophthalmologist performs the work in both eyes.
Also, Medically Unlikely Edit (MUE) for CPT code 92082 is one.
To avoid denials please bill all services performed on one day on the same claim.

Jody Posted 2 Year(s) ago

The services are all billed on the same claim. The code is billed twice because it is performed twice on each eye--not once per eye as the original response implies. The field must be performed once with the eyelids at normal position for each eye and then repeated for each eye with the eyelids taped open. It is not being billed twice due to laterality--rather, it is being billed twice because two complete sets of fields are being performed.

SuperCoder Posted 2 Year(s) ago

CPT codes 92081 through 92083 (visual field examinations) should be submitted with a days/units of '1' regardless of whether the service was performed on one eye or both eyes because the description of the code represents a 'unilateral or bilateral' service. Visual field examinations to determine the need for blepharoplasty are sometimes performed twice, once with the eye(s) taped and immediately repeated without the eye(s) taped. In this situation, the repeated service should be submitted with CPT modifier 76.

Posted by Jody, 2 Year(s). There are 4 posts. The latest reply is from SuperCoder.

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