Medicine: Ophthalmology (Q&A) (November 2016)

November 2016 page 9a Medicine: Ophthalmology Question: What are the specific elements of a complete visual system examination as part of the comprehensive ophthalmological services? Answer: CPT guidelines do not define the elements of "complete" visual system examination, but do describe what constitutes "comprehensive ophthalmological services." Codes 92004, Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits, and code 92014, Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits, describe comprehensive ophthalmological services that...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains how CPT frames comprehensive ophthalmological services and the overall scope of a complete visual system examination. It is useful for ophthalmology practices, coders, and auditors who need to understand the general categories of service elements discussed in CPT Assistant guidance.

Why This Topic Matters

Ophthalmology billing often depends on how a visit is characterized at a high level. This article helps readers understand the broad structure of comprehensive ophthalmological services and the type of CPT guidance that governs them.

Article Sections

  1. November 2016 page 9a

    Introductory publication information and the article’s ophthalmology coding topic.

  2. Medicine: Ophthalmology

    The main Q&A topic focused on comprehensive ophthalmological services and the scope of a complete visual system examination.

What You Will Learn

  • How CPT describes comprehensive ophthalmological services at a high level.
  • What broad categories of examination elements are associated with a complete visual system evaluation.
  • Why comprehensive ophthalmology services are treated as an integrated service entity.
  • The kinds of ophthalmic service topics addressed in the Q&A format.

Who Should Read This

  • Ophthalmology coders
  • Medical billers
  • Compliance staff
  • Auditors
  • Ophthalmology providers

Codes Discussed


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