How To Use CPT Code 0604T

CPT 0604T describes the provision and setup of an optical coherence tomography (OCT) machine for a patient with retinal disease, along with patient education on how to use the equipment. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0604T?

CPT 0604T can be used to describe the provision and setup of an optical coherence tomography (OCT) machine for a patient with retinal disease, along with patient education on how to use the equipment. This code is used when an ophthalmologist provides an OCT machine and remotely sets it up in the patient’s home or domicile, while also training the patient on how to operate the machine.

2. Official Description

The official description of CPT code 0604T is: ‘Optical coherence tomography (OCT) of retina, remote, patient-initiated image capture and transmission to a remote surveillance center, unilateral or bilateral; initial device provision, set-up and patient education on use of equipment.’

3. Procedure

1. The ophthalmologist provides an OCT machine and remotely sets it up in the patient’s home or domicile.
2. The patient is trained on how to use the OCT machine, including capturing and transmitting images to a remote surveillance center.
3. The ophthalmologist ensures that the patient understands how to properly operate the equipment and perform the necessary tasks for image capture and transmission.

4. Qualifying circumstances

Patients eligible to receive CPT 0604T services are those with retinal diseases or conditions that require OCT imaging for diagnosis and monitoring. This includes conditions such as macular degeneration, glaucoma, hypertensive or diabetic retinopathy, optic nerve damage, and macular holes. The ophthalmologist must provide the OCT machine and remotely set it up in the patient’s home or domicile. The patient must also be trained on how to use the equipment for image capture and transmission.

5. When to use CPT code 0604T

CPT code 0604T should be used when an ophthalmologist provides an OCT machine and remotely sets it up for a patient with retinal disease, while also providing patient education on how to use the equipment. This code should be used for the initial provision, setup, and patient instruction of the OCT machine. It is important to note that CPT code 0604T should not be reported with other codes for surveillance center technical support or image review and interpretation.

6. Documentation requirements

To support a claim for CPT 0604T, the ophthalmologist must document the following information:

• Patient’s diagnosis and the need for OCT imaging
• Details of the OCT machine provided and its setup in the patient’s home or domicile
• Date and time of the provision and setup of the OCT machine
• Documentation of patient education on how to use the equipment, including image capture and transmission
• Signature of the ophthalmologist providing the service

7. Billing guidelines

When billing for CPT 0604T, ensure that the ophthalmologist provides the OCT machine and remotely sets it up for the patient. Do not report CPT 0604T with other codes for surveillance center technical support or image review and interpretation. It is important to check with the payer regarding coverage and reimbursement for this procedure, as it may be considered investigational or not yet approved by the FDA.

8. Historical information

CPT 0604T was added to the Current Procedural Terminology system on July 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. An ophthalmologist provides an OCT machine and remotely sets it up for a patient with macular degeneration, while also educating the patient on how to use the equipment for image capture and transmission.
2. A patient with glaucoma receives an OCT machine from an ophthalmologist, who remotely sets it up in the patient’s home and provides instruction on how to perform OCT imaging for monitoring the condition.
3. An ophthalmologist provides an OCT machine and remotely sets it up for a patient with diabetic retinopathy, while also training the patient on how to capture and transmit images for diagnosis and monitoring.
4. A patient with optic nerve damage receives an OCT machine from an ophthalmologist, who remotely sets it up and educates the patient on how to use the equipment for imaging and monitoring purposes.
5. An ophthalmologist provides an OCT machine and remotely sets it up for a patient with macular holes, while also providing patient education on how to perform OCT imaging for diagnosis and monitoring.
6. A patient with hypertensive retinopathy receives an OCT machine from an ophthalmologist, who remotely sets it up in the patient’s home and trains the patient on how to use the equipment for image capture and transmission.
7. An ophthalmologist provides an OCT machine and remotely sets it up for a patient with retinal disease, while also educating the patient on how to use the equipment for image capture and transmission to a remote surveillance center.
8. A patient with diabetic retinopathy receives an OCT machine from an ophthalmologist, who remotely sets it up and provides instruction on how to perform OCT imaging for monitoring the condition.
9. An ophthalmologist provides an OCT machine and remotely sets it up for a patient with macular degeneration, while also training the patient on how to capture and transmit images for diagnosis and monitoring.
10. A patient with glaucoma receives an OCT machine from an ophthalmologist, who remotely sets it up in the patient’s home and educates the patient on how to use the equipment for imaging and monitoring purposes.