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CPT Code: 92132  Region: 02

States covered:  Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont, Wisconsin

Title:  Scanning Laser - Anterior Segment

Category
Special Ophthalmological Services

Description
Scanning computerized ophthalmic diagnostic imaging, anterior segment, unilateral or bilateral

FEE SCHEDULE



PROCEDURE DESCRIPTION

Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) is a non-invasive, non-contact imaging technique.  SCODI produces high resolution, cross-sectional tomographic images of ocular structures and is used for the evaluation of anterior segment and posterior segment disease.

Anterior segment SCODI is used in the evaluation and treatment planning of diseases affecting the cornea, iris, and other anterior chamber structures.  The procedure also may be used to provide additional information during the planning and follow-up for corneal, iris, and cataract surgeries. 

CLINICAL INDICATIONS

Anterior segment OCT is considered to be reasonable and necessary to:

      • Evaluate narrow angle, suspected narrow angle, mixed narrow and open angle glaucoma, and angle recession as all determined by gonioscopy
      • Determine the proper intraocular lens for a patient who has had prior refractive surgery and now requires cataract extraction
      • Evaluate Iris tumor
      • Evaluate corneal edema or opacity that precludes visualization or study of the anterior chamber
      • Calculate lens power for cataract patients who have undergone prior refractive surgery. (Reimbursement will only be made for the cataract codes as long as additional documentation is available in the patient record of the prior refractive procedure. Reimbursement will not be made in addition to A-scan or IOL master.)
      • Evaluate and plan treatment for patients with diseases affecting the cornea, iris, lens and other anterior segment structures.
      • Provide additional information during the planning and follow-up for corneal, iris, cataract, glaucoma and other anterior segment surgeries.


LIMITATIONS OF COVERAGE:

      • Absence of an indication
      • Screening

COVERED DIAGNOSES

ICD-10 Diagnosis Codes



DOCUMENTATION REQUIREMENTS

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.

CODING GUIDELINES

1.  Report a Scanning Computerized Ophthalmic Diagnostic Imaging, Anterior Segment test with CPT code 92132.  This is a bilateral test, therefore no modifiers are required if both eyes are examined.  A unit of “1” should be placed in the unit field of the CMS 1500 form or its electronic equivalent.

2.  If only one eye is examined, the -RT or -LT modifier should be applied to the service line.  A unit of “1” is placed in the unit field of the CMS 1500 form or its electronic equivalent.

3.  Scanning Computerized Ophthalmic Diagnostic Imaging Anterior Segment test requires general supervision by the optometrist/ophthalmologist.

4.  An eye examination may be reported on the same day with Scanning Computerized Ophthalmic Diagnostic Imaging Anterior Segment test if it is medically necessary.

UTILIZATION GUIDELINES

It is expected that these services would be performed as indicated by current medical literature and/or standards of practice.  When services are performed in excess of established parameters, they may be subject to review for medical necessity.

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