MAY 13, 2016
Corneal Hysteresis Coding: What You Need to Know
On Jan. 1, 2015, CPT published level 1 code 92145 Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report, which replaced Category III code 0181T.
The Medicare Part B allowable in 2016 is approximately $15.42. The technical component (-TC) is $6.78 and the professional component (-26) is $8.64. Medicare Advantage Plans must provide the same services as Part B. Commercial plans still consider it experimental or investigational and as such do not have an allowed amount and the patient is responsible for payment.
Corneal hysteresis can’t be paid the same day as CPT code 99211 Technician code, or the two HCPCS codes for glaucoma screening G0117 and G0118.
Level of Supervision
Under the Medicare program requirements, the test falls under general supervision where it is furnished under the physician’s overall direction and control, but the physician’s presence is not required during the performance of the test.
The physician documents the interpretation and report.