CPT Code 92270

CPT code 92270 is a medical billing code for the procedure of electro-oculography, used to assess eye movement.

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What is CPT Code 92270

CPT code 92270 is designated for electro-oculography, a diagnostic test that measures the electrical activity of the eyes to assess their function. This procedure is typically used to evaluate eye movement disorders and can be crucial in diagnosing conditions that affect the visual and nervous systems.

Does CPT 92270 Need a Modifier?

For CPT code 92270, which is used for electro-oculography, 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 of results, for example) is being billed because the technical component is being billed by another entity.

2. -TC Technical Component: Use this modifier when only the technical component of the service is being billed (i.e., the equipment and technician time), and the professional component is either provided by another provider or not billed.

3. -LT Left Side: Indicates that the service was performed on the left side of the body. This can be important for procedures that are specific to one side of the body.

4. -RT Right Side: Indicates that the service was performed on the right side of the body.

5. -50 Bilateral Procedure: This modifier is used when the procedure is performed on both sides of the body during the same operative session.

6. -59 Distinct Procedural Service: This modifier is used to indicate that a service or procedure was distinct or independent from other services performed on the same day. This can be necessary if the services are typically bundled but were performed in different sessions or patient encounters.

7. -76 Repeat Procedure by Same Physician: Use this modifier if the same provider had to repeat the electro-oculography on the same day due to specific clinical reasons.

8. -77 Repeat Procedure by Another Physician: This modifier is similar to -76 but is used when a different provider repeats the procedure on the same day.

9. -91 Repeat Clinical Diagnostic Laboratory Test: In the case of electro-oculography, this modifier might be used if the test needs to be repeated to confirm initial findings or due to an error in the initial test.

Each of these modifiers provides specific information that helps in the accurate processing and reimbursement of claims for electro-oculography. It's important to use the correct modifier to ensure compliance with billing regulations and to facilitate appropriate payment.

CPT Code 92270 Medicare Reimbursement

CPT code 92270, which pertains to electro-oculography, is generally reimbursed by Medicare. However, the reimbursement for this procedure can vary based on the 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 contact the local MAC. The reimbursement amount can also be influenced by factors such as the setting in which the procedure is performed (e.g., inpatient, outpatient) and any applicable Medicare adjustments or modifiers.

Are You Being Underpaid for 92270 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 like 92270 for electro-oculography, ensuring that each claim with individual payers is fully compensated. Schedule a demo today to see how RevFind can help secure the payments you are entitled to.

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