Visual Field Examination

August 10th, 2016 - Chris Woolstenhulme, CPC, CMRS
Categories:   CPT® Coding   Ophthalmology   Optometry  
0 Votes - Sign in to vote or comment.

The following information from one Medicare payer includes indications and limiatations of coverage as well as Medical Necessity standards for visual field examinations.

92081 Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, Autoplot, arc perimeter, or single stimulus level automated test, such as Octopus 3 or 7 equivalent)

92082 Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on Goldmann perimeter, or semiquantitative, automated suprathreshold screening program, Humphrey suprathreshold automatic diagnostic test, Octopus program 33)

92083 Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, 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)

The visual field is the area within which objects may be seen when the eye is fixed. To standardize testing, several automated and computerized perimeters are available. However, manual perimeters are also utilized.

Visual field examinations will be considered medically reasonable and necessary under any of the following conditions:

  • The patient has inflammation or disorders of the eyelids potentially affecting the visual field.
  • The patient has a documented diagnosis of glaucoma.

Please note: stabilization or progression of glaucoma can be monitored only by a visual field examination, and the frequency of such examinations is dependent on the variability of intraocular pressure measurements (e.g., progressive increases despite treatment indicate a worsening condition), the appearance of new hemorrhages, and progressive cupping of the optic nerve.

  • The patient is a glaucoma suspect as evidenced by an increase in intraocular pressure, asymmetric intraocular measurements of greater than 2-3 mm Hg between the two eyes, or has optic nerves suspicious for glaucoma which may be manifested as asymmetrical cupping, disc hemorrhage, or an absent or thinned temporal rim.
  • The patient has a documented disorder of the optic nerve,theneurologic visual pathway, or retina.

Please note: patients with a previously diagnosed retinal detachment do not need a pretreatment visual field examination. Additionally, patients with an established diagnosed cataract do not need a follow-up visual field unless other presenting symptomatology is documented. In patients about to undergo cataract extraction, who do not have glaucoma and are not glaucoma suspects, a visual field is not indicated.

  • The patient has had a recent intracranial hemorrhage, an intracranial mass, or a recent measurement of increased intracranial pressure with or without visual symptomatology.
  • The patient has a recently documented occlusion and/or stenosis of cerebral and precerebral arteries, a recently diagnosed transient cerebral ischemia, or giant cell arteritis.
  • The patient is having an initial workup for buphthalmos, congenital anomalies of the posterior segment, or congenital ptosis.
  • The patient has inflammation or disorders of the orbit, potentially affecting the visual field.
  • The patient has sustained a significant eye injury.
  • The patient has an unexplained visual loss which may be described as “trouble seeing” or “vision going in and out."
  • The patient has a pale or swollen optic nerve documented by a visual exam of recent origin.
  • The patient is having some new functional limitations which may be due to visual field loss (e.g., reports by family that patient is running into things).
Thepatientisbeingevaluatedinitiallyformacular degeneration or has experienced central vision loss resulting in vision measured at or below 20/70. Please note:repeatedexaminationsforadiagnosisofmacular degeneration or an experienced central vision loss are not necessary unless changes in vision are documented or to evaluate the results of a surgical intervention.
  • The patient is receiving or has completed treatment of a high-risk medication that may cause visual side effects (e.g., a patient on plaquenil may develop retinopathy).

– Visual Field Examination (L33766)

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

CMS and HHS Tighten Enrollment Rules and Increase Penalties
October 1st, 2019 - Wyn Staheli, Director of Research
This ruling impacts what providers and suppliers are required to disclose to be considered eligible to participate in Medicare, Medicaid, and Children's Health Insurance Program (CHIP). The original proposed rule came out in 2016 and this final rule will go into effect on November 4, 2019. There have been known problems ...
Federal Workers Compensation Information
October 1st, 2019 - Wyn Staheli, Director of Research
When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program. Division of Federal Employees' Compensation (DFEC) website Division of Federal Employees' Compensation (DFEC) provider ...
E-Health is a Big Deal in 2020
September 16th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
The new 2020 CPT codes are on the way! We are going to see 248 new codes, 71 deletions, and 75 revisions. Health monitoring and e-visits are getting attention; 6 new codes play a vital part in patients taking a part in their care from their own home. New patient-initiated ...
Chiropractic 2020 Codes Changes Are Here
September 9th, 2019 - Wyn Staheli, Director of Research
There are some interesting coding changes which chiropractic offices will want to know about. Are codes that you are billing changing?
Q/A: Is the Functional Rating Index by Evidence-Based Chiropractic Valid?
September 9th, 2019 - Wyn Staheli, Director of Research
Question Is the Functional Rating Index, from the Institute of Evidence-Based Chiropractic, valid and acceptable? Or do we have to use Oswestry and NDI? Answer You can use any outcome assessment questionnaire that has been normalized and vetted for the target population and can be scored so you can compare the results from ...
List of Cranial Nerves
September 3rd, 2019 - Find-A-Code
Cranial nerves are involved with some of our senses such as vision, hearing and taste, others control certain muscles in the head and neck. There are twelve pairs of cranial nerves that lead from the brain to the head, neck and trunk. Below is a list of Cranial Nerves and ...
So How Do I Get Paid for This? APC, OPPS, IPPS, DRG?
August 21st, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
You know how to find a procedure code and you may even know how to do the procedure, but where does the reimbursement come from?  It seems to be a mystery to many of us, so let's clear up some common confusion and review some of the main reimbursement systems.  One of the ...



About Codapedia by InnoviHealth Systems Contact Us Terms of Use Privacy Policy Advertise with Us

Codapedia™ by InnoviHealth Systems™ - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2009-2019 Find A Code, LLC - CPT® copyright American Medical Association