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Using `V80.2` code for CPT code `95930`

Lori Posted Mon 03rd of June, 2013 19:14:25 PM

Hi,

We are a primary care pediatric office who performs Visual Evoked Potential(VEP) screens for our patients at their well visits. We have been coming across many denials/pt responsiblilty for CPT code 95930 when it is billed with ICD-9 code V20.2. We did research on Supercoder and found information stating to use ICD-9 codeV80.2 with CPT code 95930 when a patient comes in for their well visit and the screen is normal(negative). When we looked up the definition for V80.2 in the ICD-9 book, it states "other eye conditions, screening for: cataract, congenital anomaly of eye, senile macular lesions." Would this ICD-9 V80.2 be appropriate to use with CPT code 95930 for a child who comes in for a well visit and has a normal read for the VEP? Please let us know.

SuperCoder Answered Wed 05th of June, 2013 21:19:49 PM

Hi,

We are very much working on this case and have consulted our editor for this to make sure you get the correct answer. He will work on this and get back to you soon.

Thanks

SuperCoder Answered Wed 12th of June, 2013 22:00:02 PM

The answer depends on your insurer. Some (such as Aetna) want you to report V20.2 but others will accept the V80.2 for this as long as it's not a standard vision screen and is a true VEP."

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