How To Use CPT Code 92015

CPT 92015 describes the process of determining a patient’s refractive state in order to prescribe and produce corrective lenses or contact lenses. 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 92015?

CPT 92015 can be used to describe the determination of a patient’s refractive state by an ophthalmologist. This code is used when the provider assesses the patient’s vision using a standardized vision chart, such as a Snellen chart, and adjusts lenses of varying power to correct the patient’s vision as close to 20/20 as possible. The settings and power of lenses used are then written as a prescription for eyeglasses or contact lenses.

2. Official Description

The official description of CPT code 92015 is: ‘Determination of refractive state. (Do not report 92015 in conjunction with 99173, 99174, 99177). For instrument-based ocular screening, use 99174, 99177.’

3. Procedure

1. The ophthalmologist performs the refractive state determination by having the patient look at a standardized vision chart, such as a Snellen chart.
2. The provider adds lenses of varying power and adjusts other settings while asking the patient if their vision is better or worse.
3. This process is repeated until the patient’s vision is corrected as close to 20/20 as possible.
4. The settings used and power of lenses used are then written as a prescription for eyeglasses or contact lenses.

4. Qualifying circumstances

Patients eligible to receive CPT 92015 services are those who require a determination of their refractive state in order to prescribe corrective lenses or contact lenses. This code is typically used by ophthalmologists. It should not be reported in conjunction with codes 99173, 99174, or 99177.

5. When to use CPT code 92015

CPT code 92015 should be used when an ophthalmologist performs a determination of a patient’s refractive state to prescribe corrective lenses or contact lenses. It should not be used in conjunction with codes 99173, 99174, or 99177.

6. Documentation requirements

To support a claim for CPT 92015, the ophthalmologist must document the following information:

• Patient’s refractive state determination
• Specific settings and power of lenses used
• Date of the procedure
• Signature of the ophthalmologist performing the procedure

7. Billing guidelines

When billing for CPT 92015, ensure that the provider is an ophthalmologist and that the procedure is performed to determine the patient’s refractive state. Do not report CPT 92015 in conjunction with codes 99173, 99174, or 99177. It is important to check with the patient’s payer regarding coverage and potential payment issues.

8. Historical information

CPT 92015 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates to the code since its addition.

9. Examples

1. An ophthalmologist performs a refractive state determination for a patient and prescribes corrective lenses.
2. A patient visits an ophthalmologist for a determination of their refractive state and receives a prescription for contact lenses.
3. An ophthalmologist performs a refractive state determination for a patient and prescribes both eyeglasses and contact lenses.
4. A patient undergoes a refractive state determination by an ophthalmologist and receives a prescription for progressive lenses.
5. An ophthalmologist performs a refractive state determination for a patient and prescribes specialized lenses for astigmatism.
6. A patient visits an ophthalmologist for a determination of their refractive state and receives a prescription for bifocal lenses.
7. An ophthalmologist performs a refractive state determination for a patient and prescribes tinted lenses for light sensitivity.
8. A patient undergoes a refractive state determination by an ophthalmologist and receives a prescription for prescription sunglasses.
9. An ophthalmologist performs a refractive state determination for a patient and prescribes lenses with anti-reflective coating.
10. A patient visits an ophthalmologist for a determination of their refractive state and receives a prescription for high-index lenses.