CPT Code 92082

CPT code 92082 is a medical billing code for limited visual field examinations.

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What is CPT Code 92082

CPT code 92082 is designated for visual field examination(s), specifically using limited examination techniques. This procedure involves testing the range and sensitivity of the patient's field of vision. It is typically used to detect any blind spots or areas of reduced vision which may indicate underlying eye conditions or neurological disorders.

Does CPT 92082 Need a Modifier?

For CPT code 92082, which pertains to visual field examination(s), several modifiers may be applicable depending on the specific circumstances of the examination and billing context. Here is an ordered list of common modifiers that could be used with this CPT code and the reasons for each:

1. -26 (Professional Component): This modifier is used when only the professional component of the service is being billed because the equipment or facility is provided by another entity. It indicates that the physician is charging only for their professional expertise.

2. -TC (Technical Component): Conversely, this modifier is used when only the technical component of the service is being billed. This is applicable when the physician or provider owns the equipment but does not personally interpret the examination.

3. -LT (Left Side) and -RT (Right Side): These modifiers are used to specify which eye was examined if only one eye was tested. This is crucial for accurate medical documentation and billing.

4. -50 (Bilateral Procedure): This modifier is used when the procedure is performed on both eyes during the same session. It helps in indicating that the service was bilateral, which can affect reimbursement.

5. -22 (Increased Procedural Services): This modifier is used when the work required to perform the service is substantially greater than typically required. It must be well-documented in the patient’s medical record to justify the increased service level.

6. -52 (Reduced Services): If the service provided is less than what is usually covered by the specific CPT code (e.g., if only a limited field examination is performed when a full examination is typically required), this modifier would be appropriate.

7. -59 (Distinct Procedural Service): This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day. This can be relevant if multiple procedures are performed on the same day, including additional visual field examinations.

8. -76 (Repeat Procedure by Same Physician): This modifier is used if the visual field examination needs to be repeated on the same day by the same physician, possibly due to initial unclear results.

9. -77 (Repeat Procedure by Another Physician): Similar to -76, but used if the repeat examination is performed by a different physician.

Each of these modifiers provides specific information that can affect billing and reimbursement processes, ensuring that the services rendered are accurately documented and charged.

CPT Code 92082 Medicare Reimbursement

CPT code 92082, which pertains to visual field examination(s), is generally reimbursable by Medicare under specific conditions that align with medical necessity. This code is used for less extensive visual field examinations than those described by CPT code 92083.

The reimbursement for CPT code 92082 by Medicare can vary based on the geographic location of the service provider due to the Medicare Physician Fee Schedule (MPFS) adjustments. To determine the exact reimbursement amount, it is advisable to consult the MPFS lookup tool available on the Centers for Medicare & Medicaid Services (CMS) website or through your regional Medicare administrator. This tool provides detailed information on reimbursement rates after inputting the relevant CPT code and geographic specifics.

It is crucial for healthcare providers to ensure that the documentation supports the medical necessity of the procedure in accordance with Medicare guidelines to facilitate appropriate reimbursement.

Are You Being Underpaid for 92082 CPT Code?

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