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    Ordering and Billing Gonioscopy


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    Does CPT code 92020 Gonioscopy (separate procedure) require a physician order as well as interpretation and report? Does the “separate procedure” language exclude it from being billed with other office visits or tests?

    Answer: Gonioscopy does not require a physician order as this procedure is performed by a physician, and not delegated to support staff. Chart documentation should support the medical necessity, the work performed and findings relevant to treating the patient.
    Some commercial payers interpret certain services that include the language ‘separate procedure’ as a stand-alone service. Medicare Part B follows the guidelines of NCCI edits, which may override this language, but other payers have their own edits. 

    See How to Bill ‘Separate Procedure’ CPT Codes.