How To Use CPT Code 92019

CPT 92019 describes an ophthalmological examination and evaluation performed under general anesthesia, with or without manipulation of the globe for passive range of motion or other manipulation to facilitate diagnostic examination. 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 92019?

CPT 92019 is used to describe an ophthalmological examination and evaluation that is performed under general anesthesia. During this procedure, the provider may manipulate the globe for passive range of motion or to aid in the diagnostic examination. The purpose of this examination is to assess the internal aspects of the eye and check for conditions such as glaucoma, retinal abnormalities, or tumors. This code is typically used when the patient is a child or unable to cooperate with a regular eye examination.

2. Official Description

The official description of CPT code 92019 is: ‘Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited.’

3. Procedure

1. The patient is appropriately prepped and anesthetized to ensure they are comfortable and unconscious during the examination.
2. The provider performs a limited eye examination, focusing on the internal aspects of the eye using an ophthalmoscope.
3. If necessary, the provider may manipulate the globe for passive range of motion or to aid in the diagnostic examination.
4. Once the examination is complete, the patient is awakened from general anesthesia and observed for a brief period before being released.

4. Qualifying circumstances

CPT 92019 is typically used when the patient is a child or unable to cooperate with a regular eye examination. The procedure is performed under general anesthesia to ensure the patient’s comfort and to facilitate a thorough examination of the internal aspects of the eye. The manipulation of the globe may be necessary to obtain a clear view and aid in the diagnostic examination.

5. When to use CPT code 92019

CPT code 92019 should be used when an ophthalmological examination and evaluation is performed under general anesthesia, with or without manipulation of the globe, for a patient who is unable to cooperate with a regular eye examination. This code is typically used for limited examinations that focus on the internal aspects of the eye.

6. Documentation requirements

To support a claim for CPT 92019, the provider must document the following information:

• Reason for performing the examination under general anesthesia
• Details of any manipulation of the globe performed during the examination
• Date and duration of the procedure
• Findings from the examination, including any abnormalities or conditions identified
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 92019, it is important to ensure that the procedure was performed under general anesthesia and that the globe was manipulated, if applicable. This code should be reported for limited ophthalmological examinations and evaluations. It should not be reported with other codes unless specific circumstances warrant it. It is important to follow the guidelines provided by the payer and to accurately document the procedure to support the claim.

8. Historical information

CPT 92019 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A child undergoing an ophthalmological examination and evaluation under general anesthesia to assess for retinal abnormalities.
2. A patient unable to cooperate with a regular eye examination due to a medical condition, undergoing an ophthalmological examination and evaluation under general anesthesia to check for glaucoma.
3. An individual requiring a thorough examination of the internal aspects of the eye, undergoing an ophthalmological examination and evaluation under general anesthesia to evaluate for tumors.
4. A patient with limited mobility undergoing an ophthalmological examination and evaluation under general anesthesia to assess for any abnormalities in the globe.
5. A person with a developmental disability undergoing an ophthalmological examination and evaluation under general anesthesia to facilitate a comprehensive diagnostic examination of the eye.
6. A patient with a history of uncooperative behavior during eye examinations undergoing an ophthalmological examination and evaluation under general anesthesia to ensure a thorough evaluation of the internal aspects of the eye.
7. An elderly individual with dementia undergoing an ophthalmological examination and evaluation under general anesthesia to check for any retinal abnormalities.
8. A patient with a history of eye trauma undergoing an ophthalmological examination and evaluation under general anesthesia to assess for any damage to the globe.
9. A person with a cognitive impairment undergoing an ophthalmological examination and evaluation under general anesthesia to facilitate a comprehensive examination of the eye.
10. An individual with a complex medical condition undergoing an ophthalmological examination and evaluation under general anesthesia to evaluate for any tumors in the eye.