JUN 21, 2015
How to Bill ‘Separate Procedure’ CPT Codes
Some commercial payers interpret certain services that include the language “separate procedure” as stand-alone service. Medicare Part B follows the guidelines of NCCI edits, which may override this language, but other payers have their own edits.
Commercial payers may choose not to allow an exam when billed the same day as a “separate procedure” service. These include:
- 92020 Gonioscopy (separate procedure);
- 92060 Sensorimotor examination with multiple measurements of ocular deviation with interpretation and report (separate procedure); and
- 92100 Serial tonometry (separate procedure) with multiple measurements of IOP over an extended time period with interpretation and report, and injections.
Before billing, you should check with each payer to see what they require.