CPT Code 92133

CPT code 92133 is for computerized imaging of the optic nerve, used in eye care diagnostics.

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What is CPT Code 92133

CPT code 92133 is designated for computerized ophthalmic imaging of the optic nerve. This procedure involves the use of advanced imaging technology to capture detailed images of the optic nerve, which is crucial for diagnosing and monitoring conditions such as glaucoma and other optic nerve disorders. The imaging helps healthcare providers assess the health and structure of the optic nerve with precision.

Does CPT 92133 Need a Modifier?

For CPT code 92133, which pertains to computerized ophthalmic imaging of the optic nerve, several modifiers may be applicable depending on the specific circumstances of the billing situation. Here is an ordered list of potential modifiers and the reasons for their use:

1. -26 (Professional Component): This modifier is used when only the professional component of the service (interpretation and report) is being billed because the equipment used for the imaging was not owned by the professional providing the interpretation.

2. -TC (Technical Component): This modifier is applicable when only the technical component of the service (the actual imaging service) is being billed. This is used if another entity is responsible for the interpretation of the images.

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

4. -50 (Bilateral Procedure): This modifier is used if the imaging was performed on both eyes during the same session. It indicates that the procedure was performed bilaterally and can affect reimbursement depending on payer rules.

5. -59 (Distinct Procedural Service): This modifier is used to indicate that the procedure was distinct or independent from other services performed on the same day. This might be necessary if other procedures typically bundled with this imaging are billed separately.

6. -76 (Repeat Procedure by Same Physician): Use this modifier if the same procedure (imaging of the optic nerve) is repeated in the same session by the same physician, perhaps due to initial inadequate results.

7. -77 (Repeat Procedure by Another Physician): Similar to -76, but used if the repeat imaging is performed by a different physician.

8. -22 (Increased Procedural Services): This modifier may be used if the service provided is greater than that usually required for the listed procedure, possibly due to extensive documentation or increased complexity.

9. -79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is applicable if the imaging is performed during the postoperative period of a different, unrelated surgery, and the service is distinct enough to be billed separately.

Each of these modifiers serves to provide specific details that can affect how the procedure is billed and reimbursed, ensuring accurate and fair compensation for the services provided. It's crucial to use the correct modifier to comply with payer requirements and to avoid claims denials.

CPT Code 92133 Medicare Reimbursement

CPT code 92133, which pertains to computerized ophthalmic imaging of the optic nerve, is generally reimbursed by Medicare. This code is commonly used in the management and diagnosis of glaucoma and other optic nerve disorders. Reimbursement rates for this procedure can vary based on geographic location and the specific Medicare administrative contractor (MAC) policies.

To determine the exact reimbursement amount, it is advisable to consult the Medicare Physician Fee Schedule (MPFS) available on the Centers for Medicare & Medicaid Services (CMS) website or directly through your local MAC. These resources will provide the most accurate and up-to-date information regarding reimbursement rates for CPT code 92133 in your specific area.

Are You Being Underpaid for 92133 CPT Code?

Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately detecting underpayments. With the capability to scrutinize contracts and identify discrepancies down to specific CPT codes, such as 92133 for computerized ophthalmic imaging of the optic nerve, RevFind ensures that each claim is fully compensated according to your payer agreements. Schedule a demo today to see how RevFind can help secure the payments you are entitled to from every individual payer.

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