Print | ShareCPT Code: 92286 Region: 05
States covered: Florida, Puerto Rico, Virgin Islands
Title: Specular Endothelial Microscopy
Category
Special Ophthalmological Services
Description
Special anterior segment photography with interpretation and report, with specular endothelial microscopy and cell count
Specular endothelial microscopy is a technique to obtain high magnification photographic images of the endothelial cells of the cornea.
1. Identification and/or follow-up for disorders of endothelial cell function
- Assessment of corneal edema
- Assessment of endothelial corneal dystrophy
2. Identification and/or follow-up for disorders of the lens
- Aphakia
- Congential aphakia
- Pseudo-aphakia
ICD-10 Diagnosis Codes
| ICD-10 Codes | Description |
|---|---|
| H18.10 - H18.13 | Bullous keratopathy, unspecified eye - Bullous keratopathy, bilateral |
| H18.20 | Unspecified corneal edema |
| H18.221 - H18.239 | Idiopathic corneal edema, right eye - Secondary corneal edema, unspecified eye |
| H18.51 | Endothelial corneal dystrophy |
| H18.59 | Other hereditary corneal dystrophies |
| H27.00 - H27.03 | Aphakia, unspecified eye - Aphakia, bilateral |
| Q12.3 | Congenital aphakia |
| Z96.1 | Presence of intraocular lens |
The optometrist/ophthalmologist has a responsibility to maintain a record for postpayment audit.
- Notes supplying documentation of complaint or symptomatology for visual disturbances and the affect on activities of daily living
- Specular photomicrographs
1. Report specular endothelial microscopy with CPT code 92286. This is bilateral test and therefore includes both eyes when submitted without a modifier. The procedure should be reported on a single service line without the -50, -RT or -LT modifiers and a unit of “1” is placed in the unit field of the CMS 1500 form or its electronic equivalent.
2. Specular endothelial microscopy requires personal supervision by the optometrist/ophthalmologist.
3. An eye examination may be reported on the same day as specular endothelial microscopy if it is medically necessary.
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.
A National Coverage Determination precludes separate coverage of specular endothelial microscopy in patients undergoing cataract surgery in whomever there are no visual problems related to known corneal conditions. Therefore, specular endothelial microscopy is not medically necessary if it is performed as part of a preoperative examination for cataract surgery when the only visual problem is cataracts.