AMA CPT® Assistant - 1998 Issue 8 (August)
Coding for Ophthalmological Services (August 1998)
August 1998 pages 1-4 Coding for Ophthalmological Services The guidelines for intermediate ophthalmological services were revised in CPT 1998 to include the verbiage "for ophthalmoscopy." This was done to clarify the use of mydriasis for ophthalmoscopy. Mydriasis is the increase in pupil size that normally occurs in the dark or artificially through the use of drugs. To facilitate ophthalmoscopy, the physician may utilize a mydriatic agent to dilate the pupils to help the physician better visualize the ocular media and fundus. The use of mydriasis for ophthalmoscopy is included in the intermediate ophthalmological services and is not normally...
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Article Overview
This article explains how CPT distinguished categories of ophthalmological services in 1998 and how those categories relate to broader evaluation and management reporting. It is aimed at coders, billers, and ophthalmology practices that need to understand which services are part of general or intermediate eye exams versus separately reportable ophthalmic services, as well as related contact lens and spectacle service guidance.
Why This Topic Matters
Ophthalmology coding often depends on whether a service is bundled into an exam category or separately reportable. This article helps readers recognize the scope of CPT ophthalmological service categories and identify the related code families discussed in the 1998 guidance.
Article Sections
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Intermediate Services
Covers the scope of intermediate ophthalmological services and the types of exam components discussed in CPT guidance. The section also notes how these services relate to ophthalmoscopy-related examination elements.
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Comprehensive Services
Describes comprehensive ophthalmological services and the broad visual-system evaluation they include. It also discusses the general examination components and diagnostic elements associated with this service level.
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Comprehensive Ophthalmological Services
Provides additional discussion of examination methods and diagnostic components used in comprehensive ophthalmological services. The section addresses the role of specific clinical techniques within that service category.
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General Ophthalmological Services
Explains the general ophthalmological service category, including patient status concepts and how these services relate to evaluation and management reporting. It also introduces related exam components and follow-up considerations.
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Contact Lens Services
Discusses contact lens-related services, including prescription, fitting, supply, and follow-up concepts. The section distinguishes these services from general ophthalmological services.
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Spectacle Services (Including Prothesis for Aphakia)
Reviews spectacle-related services and the distinction between refractive-state evaluation and spectacle fitting. It also notes the relationship between fitting, supply, and related ophthalmological service categories.
What You Will Learn
- How CPT organized ophthalmological services into general, intermediate, comprehensive, and special categories
- Which ophthalmology-related services are discussed as part of broader exam categories versus separately reportable services
- How contact lens and spectacle services are treated in the article’s CPT guidance
- How the article relates ophthalmological services to evaluation and management reporting
- What types of ophthalmic diagnostic and examination concepts are addressed in the 1998 guidance
Who Should Read This
- Medical coders
- Ophthalmology practices
- Billing staff
- Compliance teams
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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