CPT Code 92083

CPT code 92083 is used for billing comprehensive visual field examinations.

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What is CPT Code 92083

CPT code 92083 is designated for extensive visual field examinations. This procedure involves a detailed assessment of the patient's field of vision, typically using automated equipment to map and measure the visual capabilities and detect any deficiencies or abnormalities across the entire range of vision. This test is crucial for diagnosing and managing conditions that affect peripheral vision, such as glaucoma.

Does CPT 92083 Need a Modifier?

For CPT code 92083, which pertains to visual field examination(s), several modifiers may be applicable depending on the specific circumstances of the examination and billing requirements. 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, meaning the service was provided by the physician, but the equipment or facilities were provided by another entity.

2. -TC (Technical Component): Conversely, this modifier is used when only the technical component of the service is being billed. This applies when the equipment and technical staff are provided by the healthcare provider, but the professional interpretation is done by another physician.

3. -LT (Left Side) and -RT (Right Side): These modifiers are used to specify which eye was examined if only one eye was tested. -LT indicates the left eye and -RT indicates the right eye.

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. -59 (Distinct Procedural Service): This modifier is used to indicate that the service is distinct or independent from other services performed on the same day. This could be relevant if multiple tests or procedures are performed on the same patient in a single day.

6. -22 (Increased Procedural Services): This modifier may be used when the work required to perform the service is substantially greater than typically required. It is important to document the extra work and reason in the patient’s record.

7. -76 (Repeat Procedure by Same Physician): This modifier is used if the test needs to be repeated in the same session by the same physician, possibly due to initial unclear results.

8. -77 (Repeat Procedure by Another Physician): Similar to -76, but used if the procedure is repeated by a different physician on the same day.

Each of these modifiers provides specific information that can affect billing and reimbursement processes, ensuring that the services rendered are accurately documented and charged. Always check with specific payer policies as the applicability of modifiers can vary by insurer.

CPT Code 92083 Medicare Reimbursement

CPT code 92083, which refers to visual field examination(s), is generally reimbursed by Medicare. This code is used for extensive visual field testing and is typically covered when medically necessary, such as in the diagnosis and monitoring of glaucoma and other neurological or retinal conditions.

The reimbursement amount for CPT code 92083 can vary based on geographic location and the setting in which the service is provided (e.g., office vs. facility). To obtain specific reimbursement rates, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the CMS (Centers for Medicare & Medicaid Services) website or through Medicare Administrative Contractors (MACs) that manage claims and payments in specific regions.

Providers should ensure that documentation supports the medical necessity of the test to facilitate appropriate reimbursement and to avoid denials. Additionally, adherence to any relevant Local Coverage Determinations (LCDs) or National Coverage Determinations (NCDs) that may specify indications and limitations for this test is crucial.

Are You Being Underpaid for 92083 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and identifying underpayments with precision. RevFind specializes in detailed analysis down to the CPT code level, including specific codes such as 92083 for visual field examinations. This capability ensures that each claim with individual payers is thoroughly scrutinized, safeguarding your financial interests. Schedule a demo today to see how RevFind can help you secure the correct payments for services rendered.

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