APR 10, 2023
Moderate Level Visit for Oculofacial Surgery
Are we able to bill a level 4 evaluation and management E/M (99214) or a comprehensive Eye visit code (92014) for patients that schedule oculofacial surgeries?
Answer:Possibly. For E/M codes you need to meet or exceed two of three of the components (problem, data, risk) at a moderate level for an overall moderate risk. The decision for surgery would be a moderate risk but you would need at least a moderate problem(s) or data to meet a 99204/99214.
For a comprehensive Eye Visit code, in addition to making sure you fulfill the requirements for the comprehensive Eye Visit code (12 exam elements + dilation), you also need to ask who is the payer and does one of the nine scenarios when you should not bill an Eye
visit code apply. Please review the resources below.
Evaluation and Management Codes Fact Sheet for the Comprehensive Eye Visit Codes: 92004 and 92014