optometry and opthalmology

8/17/2019 Optometry and Opthalmology

1/44

2010 UBO/UBU Conference

Title: Optometry & Ophthalmology Coding

Session: T-3-1630


2/44


3/44

!i"#al $ield"http%//'ingcom/image"/"earch()*limited+vi"#al+field+e,am+finding"&vie*detail&id*.363

B3B6333336034B6240$&fir"t*1&$O5*7$575 1/2/113

http://www.bing.com/images/search?q=limited+visual+field+exam+findings&view=detail&id=483D63B4437D7B634D33A3A3E9AD6035B694250F&first=1&FORM=IDFRIRhttp://www.bing.com/images/search?q=limited+visual+field+exam+findings&view=detail&id=483D63B4437D7B634D33A3A3E9AD6035B694250F&first=1&FORM=IDFRIRhttp://www.bing.com/images/search?q=limited+visual+field+exam+findings&view=detail&id=483D63B4437D7B634D33A3A3E9AD6035B694250F&first=1&FORM=IDFRIRhttp://www.bing.com/images/search?q=limited+visual+field+exam+findings&view=detail&id=483D63B4437D7B634D33A3A3E9AD6035B694250F&first=1&FORM=IDFRIR


4/44

!i"#al $ield" 8 9otential iagno"e"

IC!"

# 3$%&'(: Visual )ield de)ect*

unspeci)ied

# 3$%&'+: Scotoma in,ol,ing

central area

# 3$%&'2: Scotoma o) -lind spot

area

# 3$%&'3: Sector o) arcuatede)ects

# 3$%&'': Other locali.ed ,isual

)ield de)ect

# 3$%&'/: 0enerali.ed

contraction or constriction # 3$%&'$: 1omonymous -ilateral

)ield de)ects

# 3$%&': 1eteronymous

-ilateral )ield de)ects

IC!+(

# 1/3&'( nspeci)ied ,isual )ield

de)ects

# 1/3&'++! 1/3&'+": Scotoma

in,ol,ing central area

# 1/3&'2+ # 1/3&'2": Scotoma

o) -lind spot area

# 1/3&'3+ # 1/3&'3": Sector orarcuate de)ects

# 1/3&'/+ # 1/3&'/": Other

locali.ed ,isual )ield de)ect

# 1/3&'$+ # 1/3&'$":

1omonymous -ilateral )ield

de)ects

# 1/3&': 1eteronymous -ilateral

)ield de)ects

# 1/3&'%+ # 1/3&'%":

0enerali.ed contraction o)

,isual )ield'


5/44

!i"#al $ield Terminology

9erimetry% 4 test in 5hich a topographic 6map7 is created o) the

,isual )ield* to diagnose and e,aluate diseases o) optic ner,e* retina*and neuroophthalmic 0oldmann perimetry8 uses -oth stationary#

static light sources o) increasing intensity and mo,ing light sources

to delineate the ,isual )ield* de)ects o) 5hich can -e either central or

peripheral # 9c0ra5!1ill Concise ictionary o) 9odern 9edicine& 2((2 -y The 9c0ra5!1ill Companies* Inc&8

http:;;medical!dictionary&the)reedictionary&com;perimetry +;2;++

:tatic perimetry% 9easurement o) the ,isual )ield 5ith a target that

can -e ,aried in dimension and luminance& The target can -e

presented in any part o) the ,isual )ield # 9illodot: ictionary o) Optometry and Visual Science* th edition& 2(("


6/44

;imited !i"#al $ield ,am

"2(%+: Visual )ield examination* unilateral or -ilateral* 5ith

interpretation and report8 limited examination >e&g&* tangentscreen* 4utoplot* arc perimeter* or single stimulus le,el

automated test* such as Octopus 3 or e=ui,alent?

$


7/44

Tangent :creen !i"#al $ield


8/44

;imited !i"#al $ield

Image Source Page:

http:;;5e-eye&ophth&uio5a&edu;ips;Perim

etry1istory;3!perimeter&htm +;2;++

http:;;555&hudsoneyemd&com;images;Octo

pus@2(,isual@2()ield&gi) +;2%;++

%

http://webeye.ophth.uiowa.edu/ips/PerimetryHistory/3-perimeter.htmhttp://webeye.ophth.uiowa.edu/ips/PerimetryHistory/3-perimeter.htmhttp://www.hudsoneyemd.com/images/Octopus%20visual%20field.gifhttp://www.hudsoneyemd.com/images/Octopus%20visual%20field.gifhttp://www.hudsoneyemd.com/images/Octopus%20visual%20field.gifhttp://www.hudsoneyemd.com/images/Octopus%20visual%20field.gifhttp://webeye.ophth.uiowa.edu/ips/PerimetryHistory/3-perimeter.htmhttp://webeye.ophth.uiowa.edu/ips/PerimetryHistory/3-perimeter.htm


9/44

7ntermediate !i"#al $ield ,am

"2(%2: Visual )ield examination* unilateral or -ilateral* 5ith

interpretation and report* intermediate examination >e&g&* atleast 2 isopters on 0oldmann perimeter* or

semi=uantitati,e* automated suprathreshold screening

program* 1umphrey suprathreshold automatic diagnostic

test* Octopus program 33?

"


10/44

7ntermediate !i"#al $ield

+(

http:;;555&glaucoma!eye!in)o&com;images;Perimeter!chart&gi) +;2%;++

http://www.glaucoma-eye-info.com/images/Perimeter-chart.gifhttp://www.glaucoma-eye-info.com/images/Perimeter-chart.gif


11/44

,tended !i"#al $ield ,am

"2(%3: Visual )ield examination* unilateral or -ilateral* 5ith

interpretation and report* extended examination >e&g&* 5ithat least 3 isopters plotted and static determination 5ithin

the central 3( degrees* or =uantitati,e* automated

threshold perimetry* Octopus program 0!+* 32* or '2*

1umphrey ,isual )ield analy.er )ull threshold programs 3(!2* 2'!2* or 3(;$(!2?

++


12/44


13/44

=#mphrey !i"#al $ield

Image Source Page:http://www.ammaieehospital.com/special!ee!care!"acilities.html

Image Source Page:http://www.ees2sea.com.au/#ontent$#ommon/inde%.asp%Id'70(70)(0!2*+,!-!+)#!(1(,7*+01)

+3

http://www.ammayieyehospital.com/special-eye-care-facilities.htmlhttp://www.ammayieyehospital.com/special-eye-care-facilities.htmlhttp://www.eyes2sea.com.au/Content_Common/index.aspx?Id=70D70AD0-26BE-4F51-B5AC-D58DE76B081Ahttp://www.eyes2sea.com.au/Content_Common/index.aspx?Id=70D70AD0-26BE-4F51-B5AC-D58DE76B081Ahttp://www.eyes2sea.com.au/Content_Common/index.aspx?Id=70D70AD0-26BE-4F51-B5AC-D58DE76B081Ahttp://www.eyes2sea.com.au/Content_Common/index.aspx?Id=70D70AD0-26BE-4F51-B5AC-D58DE76B081Ahttp://www.eyes2sea.com.au/Content_Common/index.aspx?Id=70D70AD0-26BE-4F51-B5AC-D58DE76B081Ahttp://www.eyes2sea.com.au/Content_Common/index.aspx?Id=70D70AD0-26BE-4F51-B5AC-D58DE76B081Ahttp://www.ammayieyehospital.com/special-eye-care-facilities.htmlhttp://www.ammayieyehospital.com/special-eye-care-facilities.html


14/44

oc#menting !i"#al $ield ,am"

413 oc#mentation 5e)#irement" for ll

9roced#ral 7nterpretation and 5eport # 4lthough the interpretation does not ha,e to -e a separate page*

the summary o) the )indings must contain su))icient detail that a

conclusion o) the signi)icance o) the )indings can -e made&

# ocumentation must include a descripti,e summary& Simply

clicing the procedure in 41T4 is not ade=uate documentation

to support coding o) a procedure&

Ghat 5ould -e appropriate documentationA # Copy o) ,isual )ield report )rom de,ice

# Pro,ider7s interpretation o) de,ice report;printout in 41T4*including note5orthy )indings* relia-ility o) test* changes )rom

prior ,isual )ield exam

+'


15/44+/

http:;;555&superstoc&com;stoc!photos!images;+/"! 2;+;++

Color !i"ion

http://www.superstock.com/stock-photos-images/1597-http://www.superstock.com/stock-photos-images/1597-


16/44

Color !i"ion 8 9otential iagno"e"

IC!" # 3$%&/+: Protan e)ect

# 3$%&/2: eutan e)ect

# 3$%&/3: Tritan e)ect

# 3$%&/': 4chromatopsia

# 3$%&//: 4c=uired color,ision de)iciencies

# 3$%&/": Other color ,ision

de)iciencies

IC!+( # 1/3&/(: nspeci)ied color

,ision de)iciencies >Color

-lindness HOS?

# 1/3&/+: 4chromatopsia

# 1/3&/2: 4c=uired color

,ision de)iciency

# 1/3&/3: euteranomaly

# 1/3&/': Protanomaly

# 1/3&//: Tritanomaly

# 1/3&/": Other color ,isionde)iciencies

+$


17/44

"22%3: Color ,ision examination* extended* e&g&*

anomaloscope or e=ui,alent # Color ,ision testing 5ith pseudoisochromatic plates >such as

1 or Ishihara? is not reported separately& It is included in the

appropriate general or ophthalmological ser,ice* or ""+2&

""+2: Visual )unction screening* automated or semi!automated -ilateral =uantitati,e determination o) ,isual

acuity* ocular alignment* color ,ision -y

pseudoisochromatic plates* and )ield o) ,ision >may

include all or some screening o) the determination>s? )or

contrast sensiti,ity* ,ision under glare? # This ser,ice must employ graduated ,isual acuity stimuli that

allo5 a =uantitati,e determination o) ,isual acuity >e&g&* Snellen

chart?& This ser,ice may not -e used in addition to a general

ophthalmological ser,ice or an E;9 ser,ice

Color !i"ion Te"ting

+


18/44

Image Source Page:http://www.roinsonscamera.com/color$lindness$test.htm /27/

Ishihara 3PIP4 5est

Image Source Page:http://www.ute%as.edu/nursing/simla/html/picture/inde%.h

tml /27/

Image Source Page: http://www.caleecare.org/vision"unctions.html /27/


+%

http://www.robinsonscamera.com/color_blindness_test.htmhttp://www.robinsonscamera.com/color_blindness_test.htmhttp://www.utexas.edu/nursing/simlab/html/picture/index.htmlhttp://www.utexas.edu/nursing/simlab/html/picture/index.htmlhttp://www.caleyecare.org/visionfunctions.htmlhttp://www.caleyecare.org/visionfunctions.htmlhttp://www.utexas.edu/nursing/simlab/html/picture/index.htmlhttp://www.utexas.edu/nursing/simlab/html/picture/index.htmlhttp://www.robinsonscamera.com/color_blindness_test.htmhttp://www.robinsonscamera.com/color_blindness_test.htm


19/44

Image Source Page:http://wevision.med.utah.edu/6all#olor.html

Image Source Page:http://retina.umh.es/wevision/kallcolor.html

Image Source Page:http://www.e!m"p.org/2001vn2/,thamutol$ocular$to%icit2.html

Image Source Page: http://www.imotec.com/products/2*/


+"

http://webvision.med.utah.edu/KallColor.htmlhttp://webvision.med.utah.edu/KallColor.htmlhttp://retina.umh.es/webvision/kallcolor.htmlhttp://www.e-mfp.org/2008v3n2/Ethambutol_ocular_toxicity2.htmlhttp://www.e-mfp.org/2008v3n2/Ethambutol_ocular_toxicity2.htmlhttp://www.imbotec.com/products/126/http://www.imbotec.com/products/126/http://www.e-mfp.org/2008v3n2/Ethambutol_ocular_toxicity2.htmlhttp://www.e-mfp.org/2008v3n2/Ethambutol_ocular_toxicity2.htmlhttp://retina.umh.es/webvision/kallcolor.htmlhttp://webvision.med.utah.edu/KallColor.htmlhttp://webvision.med.utah.edu/KallColor.html


20/44

Color !i"ion Te"ting 8 nomalo"cope

Image Source Page:http://www.colourmed.com/tests.html

2(

http://www.colourmed.com/tests.htmlhttp://www.colourmed.com/tests.html


21/44


ocumenting results:

# Ishihara: J missed o,er J tested >+'?

# F44HT: Pass;Fail

# +/* F9!+((: Should include scoring sheets and

pro,ider documents interpretation o) )indings

# 4nomaloscope: Hotation o) )indings and pro,ider7s

interpretation

2+


22/44

22

:en"orimotor Te"ting

http:;;555&optomshop&co&u;stereo)lytest&htm 2;+;++

http://www.optomshop.co.uk/stereo_fly_test.htmhttp://www.optomshop.co.uk/stereo_fly_test.htm


23/44

IC!" # 3$&/+: Paresis o) accommodation

# 3$&/2: Total or complete internal ophthalmoplegia

# 3$&/3: Spasm o) accommodation

# 3$%&((: 4m-lyopia* unspeci)ied

# 3$%&(+: Stra-ismic am-lyopia

# 3$%&(2: epri,ation am-lyopia

# 3$%&2: iplopia

# 3$%&3(:


24/44

:en"orimotor Te"ting 8 9otential iagno"e"

IC!+( # 1/(&(xxx: Esotropia

# 1/(&+xxx: Exotropia

# 1/(&2x: Vertical stra-ismus

# 1/(&3xxx: Intermittent heterotropia

# 1/(&'xxx: Other D unspeci)ied heterotropia

# 1/(&/xx: 1eterophoria

# 1/(&$xxx: 9echanical stra-ismus

# 1/(&%xxx: Other speci)ied stra-ismus

# 1/(&": nspeci)ied stra-ismus

# 1/+&(: Palsy o) conKugate ga.e

# 1/+&+x: Con,ergence insu))iciency D excess

# 1/+&2x: Internuclear ophthalmoplegia

# 1/+&%: Other speci)ied disorders o) -inocular mo,ement

# 1/+&": nspeci)ied disorder o) -inocular mo,ement

# 1/3&(xx: 4m-lyopia

# 1/3&2: iplopia

# 1/3&3x: Other and unspeci)ied disorders o) -inocular ,ision

2'


25/44

"2($(: Sensorimotor examination 5ith multiplemeasurements o) ocular de,iation >e&g&* restricti,e or

paretic muscle 5ith diplopia? 5ith interpretation and

report >separate procedure?

4 good de)inition )or sensorimotor testing: # Lmultiple measurements o) ocular de,iations 5ith interpretationand report& It includes measurement o) ocular alignment in more

than one )ield o) ga.e at distance and;or near >primary* up*

do5n* le)t and right ga.e? and inclusion o) at least one

appropriate sensory test in patients 5ho are a-le to respond

>andot or Titmus test?M http:;;555&medrounds&org;ophthalmology!pearls;2((";(";cpt!code!"2($(!sensorimotor

!examination&html +;2;++


2/

http://www.medrounds.org/ophthalmology-pearls/2009/09/cpt-code-92060-sensorimotor-examination.htmlhttp://www.medrounds.org/ophthalmology-pearls/2009/09/cpt-code-92060-sensorimotor-examination.htmlhttp://www.medrounds.org/ophthalmology-pearls/2009/09/cpt-code-92060-sensorimotor-examination.htmlhttp://www.medrounds.org/ophthalmology-pearls/2009/09/cpt-code-92060-sensorimotor-examination.html


26/44

Image Source Page:http://www.guldenophthalmics

.com/ccp7/Stereo!l!)cuit! 5est

Image Source Page:

http://o"tall!articulos.ha8log.com/)rticulos!/)rticulos!

Image Source Page:http://www.hakeem!s.com/main/node/2-21


2$

http://www.guldenophthalmics.com/ccp7/Stereo-Fly-Acuity-Testhttp://www.guldenophthalmics.com/ccp7/Stereo-Fly-Acuity-Testhttp://www.guldenophthalmics.com/ccp7/Stereo-Fly-Acuity-Testhttp://oftall-articulos.hazblog.com/Articulos-b1/Articulos-b1/Adaptaciones-Sensoriales-En-Estrabismo-Infantil-b1-p52.htmhttp://oftall-articulos.hazblog.com/Articulos-b1/Articulos-b1/Adaptaciones-Sensoriales-En-Estrabismo-Infantil-b1-p52.htmhttp://oftall-articulos.hazblog.com/Articulos-b1/Articulos-b1/Adaptaciones-Sensoriales-En-Estrabismo-Infantil-b1-p52.htmhttp://www.hakeem-sy.com/main/node/24238http://www.hakeem-sy.com/main/node/24238http://www.hakeem-sy.com/main/node/24238http://www.hakeem-sy.com/main/node/24238http://www.hakeem-sy.com/main/node/24238http://www.hakeem-sy.com/main/node/24238http://oftall-articulos.hazblog.com/Articulos-b1/Articulos-b1/Adaptaciones-Sensoriales-En-Estrabismo-Infantil-b1-p52.htmhttp://oftall-articulos.hazblog.com/Articulos-b1/Articulos-b1/Adaptaciones-Sensoriales-En-Estrabismo-Infantil-b1-p52.htmhttp://oftall-articulos.hazblog.com/Articulos-b1/Articulos-b1/Adaptaciones-Sensoriales-En-Estrabismo-Infantil-b1-p52.htmhttp://www.guldenophthalmics.com/ccp7/Stereo-Fly-Acuity-Testhttp://www.guldenophthalmics.com/ccp7/Stereo-Fly-Acuity-Testhttp://www.guldenophthalmics.com/ccp7/Stereo-Fly-Acuity-Test


27/44

Image Source Page:

http:;;students&cis&ua-&edu;alK+(+3;O

cular9otility&html +;2;++

Image Source Page:

http:;;555&mrcophth&com;)inalmrcophthm

c=ss;'+&html +;2;++


2

http://students.cis.uab.edu/alj1013/OcularMotility.htmlhttp://students.cis.uab.edu/alj1013/OcularMotility.htmlhttp://www.mrcophth.com/finalmrcophthmcqss/41.htmlhttp://www.mrcophth.com/finalmrcophthmcqss/41.htmlhttp://www.mrcophth.com/finalmrcophthmcqss/41.htmlhttp://www.mrcophth.com/finalmrcophthmcqss/41.htmlhttp://students.cis.uab.edu/alj1013/OcularMotility.htmlhttp://students.cis.uab.edu/alj1013/OcularMotility.html


28/44


ocumenting sensorimotor testing

# andot ;+(

# 9addox +( 17

# LTic!tac!toeN )ormat representing di))erent )ields o)

ga.e

# Hum-er o) rings or 5ings on Titmus test correctly

o-ser,ed

# Gorth ' dot # 5hich lights 5ere o-ser,ed

#

Co,er;unco,er test results

2%


29/44

Corneal Topography

2"

Image Source Page:http://www.urmc.rochester.edu/ee!institute/lasik/technolog/orscan!corneal!topographer.c"m /27/

C l T h

http://www.urmc.rochester.edu/eye-institute/lasik/technology/orbscan-corneal-topographer.cfmhttp://www.urmc.rochester.edu/eye-institute/lasik/technology/orbscan-corneal-topographer.cfm


30/44

"2(2/: Computeri.ed corneal topography* unilateral or

-ilateral* 5ith interpretation and report # >o not report "2(2/ in conKunction 5ith $/+( #

$/+?

# >"2(2/ is not used )or manual eratoscopy* 5hich is

part o) a single system E,aluation and 9anagementor ophthalmological ser,ice?

ocumentation Tips:

# Computeri.ed printout

# Pro,ider7s )indings;interpretation o) printout

# Test relia-ility

3(

Corneal Topography

C l T h 9 i l i


31/44

Corneal Topography 8 9otential iagno"e"

IC!"

# 3(&(x: Corneal lcer # 3+&2x: Corneal edema

# 3+&3x: Changes o) corneal

mem-ranes

# 3+&'x: Corneal

degenerations # 3+&/x: 1ereditary corneal

dystrophies

# 3+&$x: eratoconus

# 3+&x: Other corneal

de)ormities

# 3+&%x: Other corneal

disorders

IC!+(

# 1+%&+x:


32/44

Image Source Page:http://www.osnsupersite.com/view.asprid'717

/27/

Image Source Page: http://eewiki.aao.org/6eratoconus

/27/

Corneal Topography

32

http://www.osnsupersite.com/view.asp?rid=17873http://eyewiki.aao.org/Keratoconushttp://eyewiki.aao.org/Keratoconushttp://www.osnsupersite.com/view.asp?rid=17873


33/44

Oc#lar 9hotography

http:;;555&ops5e-&org;OpPhoto;Extern;9otility;9otility2&html 2;+;++

33

O l 9h t h

http://www.opsweb.org/OpPhoto/Extern/Motility/Motility2.htmlhttp://www.opsweb.org/OpPhoto/Extern/Motility/Motility2.html


34/44

Codes:

# "22/(: Fundus photography 5ith interpretation and report # "22%/: External ocular photography 5ith interpretation and

report )or documentation o) medical progress >e&g&* close!up

photography* slit lamp photography* goniophotography* stereo!

photography?

# "22%$: Special anterior segment photography 5ith interpretation

and report8 5ith specular endothelial microscopy and cell count

ocumenting interpretation;report # Photos included

# Hote5orthy )indings* changes )rom pre,ious exam* etc&

Oc#lar 9hotography

3'

O l 9h t h


35/44

Image Source Page:http://www.9hu.edu/wct/coms/patient/photog/"undusa.htm

Image Source Page:http://emedicine.medscape.com/article/221*1!overview

Image Source Page:http://weee.ophth.uiowa.edu/ee" orum/tutorials/photog

Image Source Page:http://www.cuttingedgecnc

.com/digcam!mt.htm

Image Source Page:

http://drsool.com/(e"ault.asp%logentrid'

Oc#lar 9hotography

3/

http://www.jhu.edu/wctb/coms/patient/photog/fundus1a.htmhttp://www.jhu.edu/wctb/coms/patient/photog/fundus1a.htmhttp://emedicine.medscape.com/article/1228681-overviewhttp://emedicine.medscape.com/article/1228681-overviewhttp://webeye.ophth.uiowa.edu/eyeforum/tutorials/photography.htmhttp://webeye.ophth.uiowa.edu/eyeforum/tutorials/photography.htmhttp://www.cuttingedgecnc.com/digcam-mt.htmhttp://www.cuttingedgecnc.com/digcam-mt.htmhttp://drsobol.com/Default.aspx?blogentryid=33http://drsobol.com/Default.aspx?blogentryid=33http://www.cuttingedgecnc.com/digcam-mt.htmhttp://www.cuttingedgecnc.com/digcam-mt.htmhttp://webeye.ophth.uiowa.edu/eyeforum/tutorials/photography.htmhttp://webeye.ophth.uiowa.edu/eyeforum/tutorials/photography.htmhttp://emedicine.medscape.com/article/1228681-overviewhttp://emedicine.medscape.com/article/1228681-overviewhttp://www.jhu.edu/wctb/coms/patient/photog/fundus1a.htmhttp://www.jhu.edu/wctb/coms/patient/photog/fundus1a.htm


36/44

,tended Ophthalmo"copy

http:;;555&-ing&com;images;searchA

=BExtendedophthalmoscopyD,ie5BdetailDidB++3F(($C3("


37/44

"222/: Ophthalmoscopy* extended* 5ith retinal dra5ing

>e&g&* )or retinal detachment* melanoma?* 5ithinterpretation and report* initial

""22$: Ophthalmoscopy* extended* 5ith retinal dra5ing

>e&g&* )or retinal detachment* melanoma?* 5ith

interpretation and report* su-se=uent


3



38/44

612.1 Ophthalmo"copy

# Extended >"222/? and su-se=uent >"222$? ophthalmoscopy areconsidered reasona-le and necessary ser,ices )or e,aluation o) tumors

o) the retina and choroid >the tumor may -e too peripheral )or an

accurate photograph?* retinal tears* detachments* hemorrhages*

exudati,e detachments* and retinal de)ects 5ithout detachment* as 5ell

as other ocular de)ects 5hen the patient7s medical record meets the

documentation re=uirements set )orth in this policy& These codes arereser,ed )or the meticulous e,aluation o) the eye and detailed

documentation o) a se,ere ophthalmologic pro-lem 5hen photography

is not ade=uate or appropriate

612.2 $re)#ency of :ervice

# Fre=uency )or pro,iding these ser,ices depends on the medicalnecessity o) each patient and this* o) course* relates to the diagnosis& 4

serious retinal condition must exist or -e suspected* -ased on routine

ophthalmoscopy* 5hich re=uires )urther detailed study


3%



39/44

612.3 edical >ece""ity

# In all instances* extended ophthalmoscopy must -e medicallynecessary& It must add in)ormation not a,aila-le )rom the

standard e,aluation ser,ices or in)ormation that 5ill

demonstra-ly a))ect the treatment plan& It is not medically

necessary* )or example* to con)irm in)ormation already a,aila-le

-y other means


3"



40/44

612. a?or Criteria

# These criteria must -e met: 4 serious retinal condition is present -ased on ophthalmoscopy*

5hich re=uires )urther study* such as the detailed study o) pre!retinal

mem-rane* a retinal tear detachment* a suspected retinal tear 5ith

sudden onset o) symptomatic )loaters or ,itreous hemorrhage

4nother diagnostic techni=ue in addition to routine direct and indirect

ophthalmoscopy is necessary and documented8 )or example 3$(Q

scleral depressions* )undus contact lens* or "(!diopter lens

The techni=ue and )indings o) the extended ophthalmoscopy must

-e documented* including a three!dimensional representation or an

extended colored retinal dra5ing& Setches and templates are not

accepta-le& The documentation o) )ollo5!up ser,ices >"222$? mustinclude an assessment o) the change )rom pre,ious examinations

ocumentation supporting the medical necessity o) this item* such

as IC!" codes* must -e su-mitted 5ith each encounter


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CPT 2(++ Pro)essional Edition* 4merican 9edical

4ssociation IC!"*

IC!+(

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optometry and opthalmology

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