Print | ShareCPT Code: 92025 Region: 37
States covered: General guidelines if your state does not have a local coverage determination
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.
This Medicare carrier does not have a local coverage determination (LCD) for corneal topography. The policy presented is provided to serve as a sample for how other carriers allow the procedure to be billed and coded. It is provided as a reference guide only and should not be construed as policy for your current Medicare carrier.
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. This diagnostic test is used to provide a detailed map or chart of the physical features and shape of the anterior surface of the cornea. Topographic analysis permits a more accurate portrayal of the physical state of the cornea and the subtle detection of corneal surface irregularity and astigmatism.
1. Identification and/or follow-up for corneal disease causing irregular astigmatism and visual impairment.
- Keratoconus
- Bullous keratopathy
- Corneal ectasia
- Corneal degenerations
- Anterior corneal dystrophies
2. Identification and/or follow-up for conjunctival disease causing irregular astigmatism and visual impairment.
- Pterygium
3. Identification of monocular diplopia due to corneal irregularity.
4. Identification and/or follow-up for ocular injury causing large amounts of regular astigmatism or irregular astigmatism.
5. Evaluation of irregular astigmatism prior to cataract surgery.
6. Identification and/or follow-up for ocular surgery causing large amounts of regular astigmatism or irregular astigmatism.
- Eyelid surgery
- Glaucoma surgery
- Corneal transplant surgery
ICD-10 Diagnosis Codes
1. Medical record documentation submitted by the ordering/referring eye doctor should indicate the medical necessity for performing the procedure and the results derived from the corneal topography procedure. This information is usually found in the history and physical, office/progress notes and the topography map 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.
To diagnose and treat most corneal diseases, it is rarely necessary to perform more than two corneal topography tests in a twelve-month period.