How To Use CPT Code 92020

CPT 92020 is a code used for gonioscopy procedures, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 92020?

CPT 92020 is a medical billing code used to describe a gonioscopy procedure. Gonioscopy is an examination of the angle of the anterior chamber of the eye, which is the area where the iris and cornea meet. This procedure is essential for diagnosing and monitoring glaucoma-related conditions and is performed as a separate procedure unrelated to any other service or procedure performed on the eye at the same time.

2. 92020 CPT code description

The official description of CPT code 92020 is: “Gonioscopy (separate procedure)”.

3. Procedure

The 92020 procedure involves the following steps:

1. Application of topical anesthesia to the eye.
2. Placement of a special lens (goniolens) on the cornea.
3. Use of an operating microscope or slit-lamp to shine a bright light into the patient’s eye.
4. Examination of the angle where the iris and cornea meet.
5. Determination of the type of glaucoma, if present, as either open-angle or closed-angle type.
6. Completion of the test, which is painless and takes less than five minutes.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 92020 services are those who require an examination of the angle of the anterior chamber of the eye for the diagnosis and monitoring of glaucoma-related conditions. This may include patients with a family history of glaucoma, those experiencing symptoms of glaucoma, or those with other risk factors for the condition.

5. When to use CPT code 92020

It is appropriate to bill the 92020 CPT code when a provider performs a gonioscopy as a separate procedure unrelated to any other service or procedure performed on the eye at the same time. This code should not be used in conjunction with other codes for related procedures, such as 0621T or 0622T. If a gonioscopy is performed under general anesthesia, CPT code 92018 should be used instead.

6. Documentation requirements

To support a claim for CPT 92020, the following information should be documented:

• Patient’s medical history, including any risk factors for glaucoma.
• Reason for the gonioscopy procedure.
• Details of the procedure, including the use of anesthesia, goniolens, and operating microscope or slit-lamp.
• Findings from the examination of the angle of the anterior chamber of the eye.
• Type of glaucoma diagnosed, if applicable.
• Any additional procedures or services performed on the eye during the same encounter.

7. Billing guidelines

When billing for CPT code 92020, it is important to follow specific guidelines and rules. Do not report this code bilaterally using modifiers 50, LT, or RT. If the gonioscopy is performed on just one eye, append modifier 52 to indicate reduced services, along with modifier LT or RT to specify which eye was examined. If the procedure is performed with an unrelated procedure, append modifier 59 to indicate a distinct procedural service. Ensure that documentation supports the use of any modifiers and that the procedure is not part of a related procedure.

8. Historical information

CPT 92020 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 92020

Five similar codes to CPT 92020 and how they differ are:

1. CPT 92018: This code is used for gonioscopy procedures performed under general anesthesia, unlike CPT 92020, which is for gonioscopy without general anesthesia.
2. CPT 0621T: This code is for a specific type of gonioscopy-assisted transluminal trabeculotomy, which is a more invasive procedure than the standard gonioscopy described by CPT 92020.
3. CPT 0622T: Similar to CPT 0621T, this code is for another type of gonioscopy-assisted transluminal trabeculotomy, which is also more invasive than the standard gonioscopy.
4. CPT 92002: This code is for an initial comprehensive ophthalmological examination, which may include a gonioscopy but is not limited to this procedure.
5. CPT 92012: This code is for a subsequent comprehensive ophthalmological examination, which, like CPT 92002, may include a gonioscopy but is not limited to this procedure.

10. Examples

Here are 10 detailed examples of CPT code 92020 procedures:

1. A patient with a family history of glaucoma undergoes a gonioscopy to assess their risk for developing the condition.
2. A patient experiencing symptoms of glaucoma, such as blurred vision and eye pain, undergoes a gonioscopy to determine the presence and type of glaucoma.
3. A patient with diabetes, a known risk factor for glaucoma, undergoes a gonioscopy as part of their routine eye examination.
4. A patient with a previous diagnosis of open-angle glaucoma undergoes a gonioscopy to monitor the progression of the condition.
5. A patient with a previous diagnosis of closed-angle glaucoma undergoes a gonioscopy to monitor the effectiveness of their treatment plan.
6. A patient with a history of eye trauma undergoes a gonioscopy to assess the angle of the anterior chamber of the eye and determine if there is any damage that may increase their risk for glaucoma.
7. A patient with a narrow anterior chamber angle undergoes a gonioscopy to determine if they are at risk for angle-closure glaucoma.
8. A patient with a history of steroid use, a known risk factor for glaucoma, undergoes a gonioscopy to assess their risk for developing the condition.
9. A patient with a previous diagnosis of pigmentary glaucoma undergoes a gonioscopy to monitor the progression of the condition and the effectiveness of their treatment plan.
10. A patient with a history of uveitis, a known risk factor for glaucoma, undergoes a gonioscopy to assess their risk for developing the condition.