How To Use CPT Code 0469T

CPT 0469T describes a retinal polarization scan, which is a visual screening test used to detect retinal fixation. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0469T.

1. What is CPT Code 0469T?

CPT 0469T is a code used to describe a retinal polarization scan, a type of visual screening test. This test is particularly useful for diagnosing conditions such as strabismus and amblyopia (lazy eye) in patients who are unable to undergo standard fixation testing or are uncooperative, such as infants and children. The code includes ocular screening of both eyes and provides on-site automated results.

2. Official Description

The official description of CPT code 0469T is a retinal polarization scan, ocular screening with on-site automated results, bilateral. It is important to note that this code should not be reported in conjunction with codes 92002, 92004, 92012, or 92014. Additionally, for ocular photoscreening, a different code should be used (99174 or 99177). For optical coherence tomography (OCT) for microstructural and morphological imaging of the skin, a separate code (96999) should be used.

3. Procedure

1. The retinal polarization scan involves directing modulated polarized light through a specific pattern of nerve fibers to identify and define the region on the retina where fixation occurs.
2. This technique improves upon standard fixation testing by avoiding interference from corneal birefringence.
3. The procedure includes scanning both eyes and providing on-site automated (computer-generated) results.

4. Qualifying circumstances

CPT 0469T is appropriate for patients who require a retinal polarization scan for the diagnosis of conditions such as strabismus and amblyopia. These conditions involve misalignment of the eyes and decreased vision due to a disconnect between the eye and the brain. The test is particularly useful for patients who are unable to undergo standard fixation testing or are uncooperative, such as infants and children.

5. When to use CPT code 0469T

CPT code 0469T should be used when performing a retinal polarization scan with on-site automated results for ocular screening. It is important to note that this code should not be reported in conjunction with codes 92002, 92004, 92012, or 92014. Additionally, for ocular photoscreening, a different code should be used (99174 or 99177). For optical coherence tomography (OCT) for microstructural and morphological imaging of the skin, a separate code (96999) should be used.

6. Documentation requirements

To support a claim for CPT code 0469T, the following documentation is required:

• Documentation of the patient’s condition necessitating a retinal polarization scan
• Specific details of the retinal polarization scan procedure performed
• Date of the procedure
• Results of the on-site automated screening
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT code 0469T, it is important to ensure that the procedure performed aligns with the specific requirements of the code. This code should not be reported in conjunction with codes 92002, 92004, 92012, or 92014. Additionally, for ocular photoscreening, a different code should be used (99174 or 99177). For optical coherence tomography (OCT) for microstructural and morphological imaging of the skin, a separate code (96999) should be used.

8. Historical information

CPT code 0469T was added to the Current Procedural Terminology system on July 1, 2017. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a retinal polarization scan to diagnose strabismus and amblyopia.
2. An infant requires a retinal polarization scan for ocular screening due to uncooperativeness during standard fixation testing.
3. A child with suspected lazy eye undergoes a retinal polarization scan to confirm the diagnosis.
4. A patient with misaligned eyes undergoes a retinal polarization scan to determine the extent of the condition.
5. An individual unable to undergo standard fixation testing receives a retinal polarization scan for ocular screening.
6. A patient with decreased vision undergoes a retinal polarization scan to assess the presence of amblyopia.
7. A child with suspected strabismus undergoes a retinal polarization scan to confirm the diagnosis.
8. An adult with uncooperative behavior during standard fixation testing receives a retinal polarization scan for ocular screening.
9. A patient with a history of lazy eye undergoes a retinal polarization scan to monitor the condition.
10. An individual with a family history of strabismus undergoes a retinal polarization scan for early detection.