JAN 16, 2024
Serial Tonometry Same Day as Procedure
The physician saw a patient for three intraocular pressure readings on the same day. After the second reading, the physician performed an AC tap and YAG PI. Are we able to bill serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (CPT code 92100), or is it considered incidental to the procedures?
Answer:
CPT codes 65800, 66761 and serial tonometry are not bundled under National Correct Coding Initiative (NCCI) edits. However, the descriptor for CPT code 92100 includes the language “separate procedure.” Although Medicare does not consider the separate procedure definition, many commercial payers recognize this distinction and establish edits where separate procedures can be billed if they are the only procedure provided during an encounter. As a result, commercial payers may deny CPT code 92100 billed the same day as other procedures.