Print | ShareCPT Code: 92025 Region: 24
States covered: Kentucky, Ohio
Title: Computerized Corneal Topography
Category
Special Ophthalmological Services
Description
Computerized Corneal Topography (also known as computer-assisted video keratography (CAVK) and corneal mapping is a computer assisted diagnostic imaging technique in which a special instrument projects a series of light rings on the cornea, creating a color coded map of the corneal surface as well as a cross-section profile.
Corneal topography is a computer assisted diagnostic technique where a special instrument projects a series of light rings on the cornea, creating a color coded map of the corneal surface as well as a cross-section profile. This service is used to provide a detailed map or chart of the physical features and shape of the anterior surface of the cornea. This permits a more nearly accurate portrayal of the physical state of the cornea and for the detection of subtle corneal surface irregularity and astigmatism.
Keratoplasty that treats specific lesions of the cornea, such as phototherapeutic keratectomy that removes scar tissue from the visual axis, deals with an abnormality of the eye and is not cosmetic surgery. This local coverage determination discusses medically necessary indications and limitations for computerized corneal topography testing.
Computerized corneal topography is considered medically necessary under any of the following conditions:
- Pre-operative evaluation of irregular astigmatism for intraocular lens power determination with cataract surgery
- Monocular diplopia
- Diagnosis of early keratoconus
- Post-surgical or post-traumatic astigmatism, measuring at a minimum of 3.5 diopters
- Suspected irregular astigmatism based on retinoscopic streak or conventional keratometry
- Post-penetrating keratoplasty surgery
- Post-surgical or post-traumatic irregular astigmatism
- Certain corneal dystrophies
- Complications of transplanted cornea
- Post-traumatic corneal scarring
- Pterygium and/or corneal ectasia that cause visual impairment
Limitations:
- Corneal topography will only be allowed for a pre-operative cataract patient if documentation supports that the patient has irregular astigmatism. Its use for this purpose should be rare.
- Corneal topography is to be billed only when the diagnosis of monocular diplopia is thought to be caused by a corneal irregularity
- Corneal topography is a covered service for the above indications when medically reasonable and necessary only if the results will assist in defining further treatment. It is not covered for routine follow-up testing.
- Repeat testing is only indicated if a change of vision is reported in connection with one of the above listed conditions
- Services performed for screening purposes or in the absence of associated signs, symptoms, illness or injury as indicated above, will be denied as non-covered
- Corneal topography will be non-covered if performed pre- or post-operatively in relation to a Medicare non-covered procedure, e.g., radial keratotomy
ICD-10 Diagnosis Codes
Medical Necessity ICD-10 Codes Asterisk Explanation:
**Z96.1, Z98.41, and Z98.42 must be accompanied by ICD-10-CM code H52.211, H52.212, or H52.213.
The patient’s medical record must contain documentation that fully supports the medical necessity for services included within this LCD. This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
The patient’s record must also include the computerized corneal topography results with examination and photo interpretation.
1. Report Computerized Corneal Topography with CPT Code 92025. This is a bilateral test, therefore no modifiers are required if both eyes are examined. A unit of “1” is placed in the unit field of the CMS 1500 form or its electronic equivalent.
2. Services performed for screening purposes or lacking documentation of signs, symptoms, illness or injuries will not be covered.
3. Corneal topography will not be a covered service if it is performed pre-operatively or post-operatively for non-covered Medicare procedures such as radial or refractive keratoplasty.
4. An eye examination may be reported on the same day as corneal topography if it is medically necessary.
5. Corneal topography requires general supervision by the optometrist/ophthalmologist.
This Medicare carrier has no utilization guidelines for corneal topography. It is expected that these services would be performed as indicated by current medical literature and/or current standards of ophthalmologic practice.
In the absence of specific utilization guidelines, optometrists/ophthalmologists should adhere to CMS Ruling 95-1 (V) which states that utilization of these services should be consistent with locally acceptable standards of ophthalmic practice.