How To Use CPT Code 92014

CPT 92014 describes the comprehensive ophthalmological services provided to an established patient by an ophthalmologist. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92014?

CPT 92014 can be used to describe the comprehensive ophthalmological services provided to an established patient by an ophthalmologist. This code is used when the ophthalmologist conducts a thorough examination and evaluation of the patient’s eyes, and initiates or continues a diagnostic and treatment program based on the patient’s condition and symptoms.

2. Official Description

The official description of CPT code 92014 is: ‘Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits.’

3. Procedure

1. The ophthalmologist reviews the patient’s medical history and performs a complete general external examination of the patient’s eyes.
2. The ophthalmologist may conduct various diagnostic eye tests, such as slit-lamp viewing, exophthalmometry, tonometry, biomicroscopy, and retinoscopy, to further evaluate the patient’s eye health.
3. Based on the examination and test results, the ophthalmologist may initiate new treatment or continue with the existing treatment plan for the patient.
4. The comprehensive ophthalmological services may require more than one session between the patient and the ophthalmologist.

4. Qualifying circumstances

Patients eligible to receive CPT 92014 services are those who are established patients of the ophthalmologist. An established patient is one who has been seen by the same physician or any physician in the same group practice within the past 36 months. The ophthalmologist must conduct a comprehensive evaluation of the patient’s visual system and initiate or continue a diagnostic and treatment program based on the patient’s condition and symptoms.

5. When to use CPT code 92014

CPT code 92014 should be used when an ophthalmologist provides a comprehensive examination and evaluation of an established patient’s eyes, and initiates or continues a diagnostic and treatment program. This code is appropriate for patients who require a thorough assessment of their eye health and the management of any existing conditions.

6. Documentation requirements

To support a claim for CPT 92014, the ophthalmologist must document the following information:

• Patient’s medical history
• Results of the general external examination
• Details of any diagnostic eye tests performed
• Initiation or continuation of a diagnostic and treatment program
• Progress made by the patient and any follow-up visits scheduled
• Signature of the ophthalmologist providing the service

7. Billing guidelines

When billing for CPT 92014, ensure that the service is provided by an ophthalmologist to an established patient. Follow the specific guidelines of individual payers regarding the documentation requirements and the number of elements that need to be included in the comprehensive exam. Do not report CPT 92014 in conjunction with certain other codes, as specified in the notes. Consider using other codes, such as 92002 or 92012, if fewer elements are documented in the exam.

8. Historical information

CPT 92014 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2009, with an updated description.

9. Examples

1. An ophthalmologist conducts a comprehensive examination and evaluation of an established patient’s eyes, and initiates a treatment program for glaucoma management.
2. An ophthalmologist performs a thorough examination of an established patient’s eyes and continues the treatment program for diabetic retinopathy.
3. An ophthalmologist evaluates an established patient’s eyes and prescribes new glasses for vision correction.
4. An ophthalmologist conducts a comprehensive examination of an established patient’s eyes and recommends surgery for cataract removal.
5. An ophthalmologist evaluates an established patient’s eyes and prescribes eye drops for dry eye syndrome.
6. An ophthalmologist performs a detailed examination of an established patient’s eyes and adjusts the treatment plan for macular degeneration.
7. An ophthalmologist conducts a comprehensive evaluation of an established patient’s eyes and prescribes contact lenses for refractive error correction.
8. An ophthalmologist examines an established patient’s eyes and recommends further testing for suspected glaucoma.
9. An ophthalmologist performs a comprehensive examination of an established patient’s eyes and prescribes medication for conjunctivitis treatment.
10. An ophthalmologist evaluates an established patient’s eyes and provides counseling on proper eye care and hygiene.