SEP 28, 2017
Lifetime Requirement for Corneal Pachymetry
Question: Are we allowed to bill for CPT code 76514 Corneal pachymetry more than once?
Answer: Patients with Medicare, who have glaucoma, have a once-in-a-lifetime benefit for pachymetry; not a once per physician. If you don’t know whether the test has been billed previously for that patient, get a signed advance beneficiary notice before the test. Submit the test with modifier -GA.
For corneal conditions, you may bill the test more than once in a lifetime when medically necessary.
Learn more about pachymetry in the 1-Hour Coding Course: Testing Services Documentation Requirements.