Medical Service



Ophthalmology is the study of medical conditions related to human eye.

It deals with the diagnosis, medical and surgical treatment of eye-related disorders.

When it comes to medical billing of ophthalmology, it requires two different code sets; E&M codes and eye codes. In-depth knowledge of the following subspecialties is also necessary for ophthalmology medical billing; they include:

  • Retina
  • Pediatric
  • Glaucoma
  • Ocular Plastics

The code range for ophthalmology procedures and services is 92002 – 92499 :

CPT 92002 – 92004  : New Patient general ophthalmological services and procedures

CPT 92012 – 92014 : Established Patient general ophthalmological services and procedures

CPT 92015 – 92145 : Ophthalmological examination and evaluation procedures

CPT 92201 – 92260 : Ophthalmoscopy procedures

CPT 92265 – 92287 : Other specialised Ophthalmological services and procedures

CPT 92310 – 92326 : Contact lens services

CPT 92340 – 92371 : Spectacle services

Ophthalmology coding guidelines 2022:

CPT Codes from 92002 – 92014 are the general ophthalmological services. When reporting E&M codes, these codes should not be reported separately. The E&M services include general ophthalmological services.

  • Special ophthalmological services may be reported separately as they are recognized as significant, separately identifiable services.
  • For procedures requiring the intravenous injection of dye or other diagnostic agents, insertion of an intravenous catheter and dye injection is integral to the procedure. These procedures are not separately reportable.

The following are not separately reportable CPT codes:

36000 (Introduction of a needle or catheter)

36410 (Venipuncture)

96360-96368 (IV infusion)

96374-96376 (IV push injection)

Selective vascular catheterization codes

  • CPT codes 92230 and 92235: Fluorescein angioscopy and angiography
  • CPT code 92071 shall not be reported with a corneal procedure CPT code for a bandage contact lens applied after completion of a procedure on the cornea.
    • CPT code 92071: Fitting of contact lens for treatment of ocular surface disease.

 Following are the conditions treated by the ophthalmologists:

  • Glaucoma
  • Corneal conditions
  • Retinal Conditions
    • Diabetic retinopathy
    • Macular degeneration
  • Pediatric eye conditions and disorders
Neurological cases like:
    • Optic nerve issues
    • Double vision
    • Vision loss (few kinds)
    • Abnormal eye movements
Complex surgical procedures like:
    • Reconstructive surgery
    • Advanced vision repair

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