How To Use CPT Code 92133

CPT 92133 is a diagnostic imaging code for examining the optic nerve in the posterior segment of the eye, with interpretation and report. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 92133 procedures.

1. What is CPT 92133?

CPT 92133 is a diagnostic imaging code used by medical professionals to examine the optic nerve in the posterior segment of the eye. This code is used when a provider performs scanning computerized ophthalmic diagnostic imaging, with interpretation and report, on either one or both eyes. The purpose of this procedure is to diagnose and treat patients with symptoms indicating possible disease of the visual system.

2. 92133 CPT code description

The official description of CPT code 92133 is: “Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider uses optical coherence tomography to scan the posterior chamber of the diseased eye.
3. A computer pointing device is utilized during the process to mark the edge of the optic nerve.
4. The provider interprets the images and prepares a report of the findings.

4. Qualifying circumstances

Patients eligible to receive CPT 92133 services are those who present with symptoms indicating possible disease of the visual system. This may include, but is not limited to, patients with glaucoma, optic neuritis, or other optic nerve disorders. The provider must determine that the diagnostic imaging is medically necessary for the diagnosis and treatment of the patient’s condition.

5. When to use CPT code 92133

It is appropriate to bill CPT 92133 when the provider performs scanning computerized ophthalmic diagnostic imaging of the optic nerve in the posterior segment of the eye, with interpretation and report, for the purpose of diagnosing and treating a patient with symptoms indicating possible disease of the visual system. This code can be used for either unilateral or bilateral procedures.

6. Documentation requirements

To support a claim for CPT 92133, the following information should be documented:

• Patient’s medical history and presenting symptoms
• Physical examination findings
• Indication for the diagnostic imaging
• Details of the procedure, including the type of imaging used and the specific area(s) examined
• Interpretation of the images and any relevant findings
• Report of the findings, including any diagnoses and treatment recommendations

7. Billing guidelines

When billing for CPT 92133, keep the following guidelines in mind:

• For the same service involving the retina, use CPT 92134.
• If reporting only the professional component, append modifier 26 (Professional component) to the code.
• If reporting only the technical component, append modifier TC (Technical component) to the code, unless the hospital provided the technical component. In that case, do not append modifier TC.
• Do not append a professional or technical modifier when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 92133 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Similar codes to CPT 92133

Five similar codes to CPT 92133 and how they differentiate are:

• CPT 92134: This code is used for scanning computerized ophthalmic diagnostic imaging of the retina, rather than the optic nerve.
• CPT 92250: This code is for fundus photography, a different type of diagnostic imaging for the eye.
• CPT 92235: This code is for fluorescein angiography, a diagnostic procedure that involves injecting a dye into the bloodstream to visualize blood flow in the retina and choroid.
• CPT 92240: This code is for indocyanine green angiography, another diagnostic procedure that uses a different dye to visualize blood flow in the eye.
• CPT 92083: This code is for visual field examination, a test that measures the patient’s peripheral vision and is not an imaging procedure.

10. Examples

Here are 10 detailed examples of CPT 92133 procedures:

1. A patient with a family history of glaucoma presents with increased intraocular pressure. The provider performs CPT 92133 to examine the optic nerve for signs of glaucomatous damage.
2. A patient with a history of optic neuritis complains of decreased vision in one eye. The provider performs CPT 92133 to assess the optic nerve for signs of inflammation or damage.
3. A patient with diabetes presents with blurry vision. The provider performs CPT 92133 to evaluate the optic nerve for signs of diabetic retinopathy.
4. A patient with a history of ocular hypertension is being monitored for glaucoma progression. The provider performs CPT 92133 as part of the patient’s routine follow-up care.
5. A patient with a known optic nerve disorder presents with worsening vision. The provider performs CPT 92133 to assess the current status of the optic nerve and determine if treatment adjustments are needed.
6. A patient with a history of multiple sclerosis complains of sudden vision loss in one eye. The provider performs CPT 92133 to evaluate the optic nerve for signs of optic neuritis, a common manifestation of multiple sclerosis.
7. A patient with a suspicious optic disc appearance is referred for further evaluation. The provider performs CPT 92133 to assess the optic nerve for signs of glaucoma or other optic nerve disorders.
8. A patient with a history of ocular trauma presents with decreased vision in the affected eye. The provider performs CPT 92133 to evaluate the optic nerve for signs of damage or scarring.
9. A patient with a known optic nerve tumor is being monitored for tumor progression. The provider performs CPT 92133 as part of the patient’s routine follow-up care.
10. A patient with a history of retinal detachment surgery complains of new visual disturbances. The provider performs CPT 92133 to assess the optic nerve for signs of damage or complications related to the surgery.