How To Use CPT Code 2022F

CPT 2022F describes the performance of a dilated retinal eye exam with interpretation by an ophthalmologist or optometrist, specifically documented and reviewed, for patients with evidence of retinopathy due to diabetes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 2022F?

CPT 2022F can be used to describe the performance of a dilated retinal eye exam with interpretation by an ophthalmologist or optometrist, specifically documented and reviewed, for patients with evidence of retinopathy due to diabetes. This code is used when the provider instills dilating drops into the patient’s eye to widen the pupil and examines the back of the eye using a bright light and an ophthalmoscope to identify any signs of damage or disease in the retina and optic nerve.

2. Official Description

The official description of CPT code 2022F is: ‘Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed; with evidence of retinopathy (DM).’ This code specifically refers to the performance of a dilated retinal eye exam in patients with evidence of retinopathy due to diabetes, with interpretation and documentation by an ophthalmologist or optometrist.

3. Procedure

1. The provider instills dilating drops into the patient’s eye to widen the pupil.
2. Using a bright light and an ophthalmoscope, the provider examines the back of the eye, focusing on the retina and optic nerve.
3. The provider looks for signs of damage or disease, specifically related to retinopathy caused by diabetes.
4. The findings of the exam are interpreted and documented by the ophthalmologist or optometrist.
5. The documented findings are then reviewed by the provider.

4. Qualifying circumstances

CPT 2022F is applicable to patients with evidence of retinopathy due to diabetes. Retinopathy refers to damage to the blood vessels feeding the light-sensitive tissue at the back of the eye (the retina), which can result in impaired vision. The exam must be performed by an ophthalmologist or optometrist, who are qualified to provide vision testing and care, and who can prescribe topical and systemic medicines and perform surgery.

5. When to use CPT code 2022F

CPT code 2022F should be used when a dilated retinal eye exam is performed by an ophthalmologist or optometrist, specifically documented and reviewed, for patients with evidence of retinopathy due to diabetes. It is important to ensure that the patient meets the qualifying circumstances for this code and that the exam is performed and documented appropriately.

6. Documentation requirements

To support a claim for CPT code 2022F, the provider must document the following information:

• Evidence of retinopathy due to diabetes
• Performance of a dilated retinal eye exam
• Interpretation of the findings by the ophthalmologist or optometrist
• Review of the documented findings

7. Billing guidelines

When billing for CPT code 2022F, it is important to ensure that the exam is performed by an ophthalmologist or optometrist and that the documentation requirements are met. This code should not be reported with other codes unless specified by specific billing guidelines. It is crucial to review the payer’s guidelines and follow any specific instructions for accurate billing and reimbursement.

8. Historical information

CPT code 2022F was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates or changes to the code since its addition.

9. Examples

1. An ophthalmologist performing a dilated retinal eye exam and documenting the findings for a patient with evidence of retinopathy due to diabetes.
2. An optometrist examining the back of the eye and interpreting the results of a dilated retinal eye exam for a patient with retinopathy caused by diabetes.
3. A provider reviewing the documented findings of a dilated retinal eye exam performed by an ophthalmologist for a patient with evidence of retinopathy due to diabetes.
4. An ophthalmologist documenting and reviewing the results of a dilated retinal eye exam for a patient with diabetic retinopathy.
5. An optometrist performing a dilated retinal eye exam and interpreting the findings in a patient with evidence of retinopathy caused by diabetes.
6. A provider reviewing the documented findings of a dilated retinal eye exam performed by an optometrist for a patient with retinopathy due to diabetes.
7. An ophthalmologist examining the back of the eye and documenting the results of a dilated retinal eye exam for a patient with diabetic retinopathy.
8. An optometrist interpreting the findings of a dilated retinal eye exam performed by an ophthalmologist for a patient with evidence of retinopathy due to diabetes.
9. A provider reviewing the documented findings of a dilated retinal eye exam performed by an optometrist for a patient with diabetic retinopathy.
10. An ophthalmologist performing a dilated retinal eye exam and documenting the results for a patient with retinopathy caused by diabetes.