(Due to the OPPS delay, the implementation of the new codes, are on hold until April 1, 2002.)
Medicare will now provide payment for glaucoma screening services to eligible Medicare beneficiaries, specifically those with diabetes mellitus or a family history of glaucoma, and certain other individuals found to be at high risk of glaucoma.
The glaucoma screening procedure is stated to consist of:
(1) A dilated eye examination with an intraocular pressure measurement; and
(2) A direct ophthalmoscopy examination, or a slit-lamp biomicroscopic examination.
Two new HCPCS codes were created for glaucoma screening:
- G0117, Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
- G0118, Glaucoma screening for high risk patients furnished under the direct supervision of an optometrist or ophthalmologist
The glaucoma screening codes are assigned to APC 230, Level I Eye Tests.
Separate payment for glaucoma screening will be made only if it is the sole ophthalmologic service for which the hospital submits a bill for the visit.
For example: The services included in glaucoma screening (a dilated eye examination with an intraocular pressure measurement and direct ophthalmoscopy or slit-lamp biomicroscopy) would generally be performed during the delivery of another ophthalmologic service that is performed on the same day.
Therefore, if the screening service were the only ophthalmologic service received that same day, it would be paid under APC 230.
Please note: To avoid a rejected claim, a screening diagnosis code must be submitted on the bill. Therefore, code V80.1, Special screening for neurological, eye, and ear diseases, Glaucoma, should be reported as the diagnosis code for the glaucoma screening visit.