How To Use CPT Code 76514

CPT 76514 is a diagnostic ophthalmic ultrasound code used to determine corneal thickness. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 76514 procedures.

1. What is CPT 76514?

CPT 76514 is a diagnostic ophthalmic ultrasound code that refers to the measurement of corneal thickness using conventional contact B scan imaging. This procedure is essential for diagnosing various eye disorders and determining the appropriate treatment plan for patients.

2. 76514 CPT code description

The official description of CPT code 76514 is: “Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)”.

3. Procedure

1. The patient is seated in the exam chair, and the provider instills a topical anesthetic into one or both eyes.
2. The provider instructs the patient to focus on a distant object to steady the patient’s eye.
3. The provider aligns the ultrasound probe with the center of the cornea and moves the probe until it touches the center of the cornea.
4. The provider takes five consecutive readings.
5. The high and low readings are discarded, and the remaining measurements are averaged to determine the thickness of the cornea in microns.
6. The provider interprets the effect of the thickness of the cornea on the patient’s eye pressure readings and records the corneal measurement and interpretation in the patient’s record.

4. Qualifying circumstances

Patients eligible to receive CPT code 76514 services are those who require a diagnostic evaluation of their corneal thickness due to suspected or confirmed eye disorders. These may include, but are not limited to, patients with glaucoma, corneal edema, keratoconus, or those undergoing refractive surgery evaluations.

5. When to use CPT code 76514

It is appropriate to bill the 76514 CPT code when a provider performs a diagnostic ophthalmic ultrasound to measure the corneal thickness of one or both eyes. This procedure is necessary for diagnosing various eye disorders, determining the appropriate treatment plan, and monitoring the progress of the patient’s condition.

6. Documentation requirements

To support a claim for CPT 76514, the following information must be documented in the patient’s medical record:

• Indication for the procedure (e.g., suspected or confirmed eye disorder)
• Details of the procedure, including the use of topical anesthetic and the number of measurements taken
• Corneal thickness measurements in microns
• Provider’s interpretation of the corneal thickness and its effect on the patient’s eye pressure readings
• Any additional findings or recommendations for further evaluation or treatment

7. Billing guidelines

When billing for CPT code 76514, it is essential to follow specific guidelines and rules. If you are reporting only the physician’s interpretation for the radiology service, you should append professional component modifier 26 to the radiology code. If you are reporting only the technical component for the radiology service, you would append modifier TC to the radiology code. Note, however, that payer policy may exempt hospitals from appending modifier TC because the hospital’s portion is inherently technical. Do not append a professional or technical modifier to the radiology code when reporting a global service in which one provider renders both the professional and technical components. Additionally, do not report 76514 in conjunction with 0402T.

8. Historical information

CPT 76514 was added to the Current Procedural Terminology system on January 1, 2004. The code was changed on January 1, 2005, with the previous descriptor being “Ophthalmic ultrasound, echography, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)”.

9. Similar codes to CPT 76514

Five similar codes to CPT 76514 and how they differentiate from it are:

1. CPT 76510: This code is for a complete ophthalmic ultrasound, including both A-scan and B-scan, while CPT 76514 focuses solely on corneal pachymetry.
2. CPT 76511: This code is for an ophthalmic ultrasound with quantitative A-scan only, whereas CPT 76514 is for corneal pachymetry using B-scan imaging.
3. CPT 76512: This code is for an ophthalmic ultrasound with B-scan only, while CPT 76514 is specifically for corneal pachymetry using B-scan imaging.
4. CPT 76513: This code is for an ophthalmic ultrasound with A-scan for intraocular lens calculation, while CPT 76514 is for corneal pachymetry.
5. CPT 76516: This code is for an ophthalmic ultrasound with B-scan for the posterior segment, whereas CPT 76514 is for corneal pachymetry using B-scan imaging.

10. Examples

Here are 10 detailed examples of CPT code 76514 procedures:

1. A patient with suspected glaucoma undergoes corneal pachymetry to determine the corneal thickness and its effect on eye pressure readings.
2. A patient with a history of corneal edema has a diagnostic ophthalmic ultrasound to measure corneal thickness and monitor the condition’s progression.
3. A patient with keratoconus undergoes corneal pachymetry to assess the severity of the condition and determine the appropriate treatment plan.
4. A patient being evaluated for refractive surgery has a diagnostic ophthalmic ultrasound to measure corneal thickness and ensure they are a suitable candidate for the procedure.
5. A patient with a history of ocular trauma undergoes corneal pachymetry to assess the corneal thickness and monitor for any changes over time.
6. A patient with a corneal ulcer has a diagnostic ophthalmic ultrasound to measure the corneal thickness and determine the appropriate treatment plan.
7. A patient with a history of corneal transplant undergoes corneal pachymetry to monitor the graft’s success and detect any potential complications.
8. A patient with Fuchs’ dystrophy has a diagnostic ophthalmic ultrasound to measure corneal thickness and monitor the progression of the condition.
9. A patient with a history of uveitis undergoes corneal pachymetry to assess the corneal thickness and determine the appropriate treatment plan.
10. A patient with a suspected foreign body in the eye has a diagnostic ophthalmic ultrasound to measure corneal thickness and assess the potential impact on the eye’s structures.