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  • Designated Health Services

    What ophthalmic procedure codes are categorized as designated health services (DHS) by CMS?


    The current list of CPT and HCPCS codes designated as DHS that are most applicable to the ophthalmic practice includes the following:
    • 76510-76519: These codes apply to ophthalmic ultrasound; A-Scan, B-Scan
    • 92132-92134: These codes apply to OCT of the anterior segment, optic nerve, and retina
    • 92227-92229: These codes apply to imaging of the retina for detection or monitoring, with review and report by clinical staff or interpretation and report by physician or other qualified health professional or point of care au­tomated analysis (artificial intelligence)
    • 0330T: Tear film imaging, unilateral or bilateral, with interpretation and report
    • 83516: Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method (used for the InflammaDry test)
    • 83861: Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity (used for the TearLab diagnostic test)
    • HCPCS codes for outpatient pre­scription drugs, such as J0178 for Eylea (aflibercept) or J0585 for Botox (botuli­num toxin)

    See August 2022 EyeNet® Savvy Coder article “The Stark Law and Productivity-Based Compensation in Group Practices" for an overview of how DHS can impact physician compensation in a group practice.