New Text module
Novel codes 92071 and 92072 are to be used for lens
prescriptions for keratoconus and OSD.
Even though you can't bill Medicare for consistent
refractive lenses, savvy ophthalmology coders are aware of the fact that you
can anticipate reimbursement for contact lens prescriptions for treating
keratoconus (ICD-9 codes 371.60-371.62) as well as ocular surface disorders
(OSDs) for example corneal abrasions or dry eye. On the other hand, what coders
at present know is changing in 2012, with the removal of one familiar code and
the introduction of two novel medical CPT codes. Read on this expert insight on
accurate medical Supercoder coding.
92070 no more: The medical CPT 2012 manual scrubs the
ophthalmology coder's standby meant for therapeutic contact lenses, 92070
(Fitting of contact lens for treating disease, including supply of lens). As an
alternative, you'll find two novel codes:
92071 (Fitting of contact lens for treatment of ocular
surface disease)
92072 (Fitting of contact lens for treatment of keratoconus,
initial fitting).
Notes in the medical CPT® manual warn you against reporting
92071 with 92072. For the supply of lenses, which was included in the code
previous to 2012, CPT® recommends reporting 99070 (Supplies and materials
[except spectacles], provided by the physician over and above those usually
included with the office visit or other services rendered [list drugs, trays,
supplies, or other materials provided), or another suitable supply code.
A note associated with novel code 92072 instructs coders to
report an apt 92002-92014 (E/M or General Ophthalmological Services) code for
following listed fittings of keratoconic lenses.
Difference in Ophthalmologist's Work Means Difference in
RVUs
Why the change? Ophthalmologists were earlier using 92070 to
report two very dissimilar kinds of service. Upon assessment of this service,
the specialty societies approved that there are two distinct uses for medical
CPT® code 92070 that have significantly dissimilar levels of work.
The medical CPT® Editorial Panel decided and removed CPT®
code 92070 and then created two novel medical CPT codes (92071 and 92072) to
differentiate reporting fitting of contact lens meant for management of ocular
surface disease and fitting of contact lens for supervision of keratoconus.
To echo the fact that managing contact lens of keratoconus
involves more work for ophthalmologists than treatment of OSD, Medicare has
allocated more work RVUs to 92072 (1.97 work RVUs) as compared to 92071 (0.61
work RVUs). The work RVUs for 92071 are alike the work RVUs assigned to 92070
in 2011, sans a small number of adjustments in pre- as well as post-service
time.
