How To Use CPT Code 92136

CPT 92136 is a code used for ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation. 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 92136 procedures.

1. What is CPT 92136?

CPT 92136 is a code used to describe a noninvasive method for measuring a patient’s eye or eyes to obtain information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). This code is specifically used for ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation.

2. 92136 CPT code description

The official description of CPT code 92136 is: “Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation.”

3. Procedure

The procedure for CPT 92136 involves the following steps:

1. The provider aligns a device to the patient’s eye to begin an automated measurement process.
2. Partial coherence interferometry is used, which involves a noninvasive method such as infrared laser light to take measurements of the eye.
3. Typical measurements include axial length, lens thickness, anterior chamber depth, and corneal curvature (keratometry) for both eyes.
4. The provider then uses these measurements and software to calculate the correct intraocular lens (IOL) power, or strength, to use for the patient to achieve the desired vision outcome after cataract surgery.
5. If cataract surgery is planned for only one eye, the provider may perform the calculation only for that eye.

4. Qualifying circumstances

Patients who are eligible to receive CPT 92136 services are those who require intraocular lens power calculation prior to cataract surgery. This may include patients with cataracts, lens dislocation, or other conditions that affect the clarity of the eye’s natural lens. The provider must determine that the patient requires this specific type of biometry and that it is medically necessary for the patient’s condition.

5. When to use CPT code 92136

It is appropriate to bill the 92136 CPT code when a provider performs ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation for a patient who requires this service prior to cataract surgery or other lens-related procedures. The provider must ensure that the service is medically necessary and that the patient meets the qualifying circumstances for this code.

6. Documentation requirements

To support a claim for CPT 92136, the provider must document the following information:

• The medical necessity for the service, including the patient’s diagnosis and the reason for performing ophthalmic biometry by partial coherence interferometry.
• A detailed description of the procedure, including the measurements taken and the method used for intraocular lens power calculation.
• The results of the biometry and the calculated intraocular lens power.
• Any additional relevant information, such as the patient’s ocular history or the presence of any complicating factors.

7. Billing guidelines

When billing for CPT code 92136, it is important to follow the appropriate guidelines and rules. Some tips for billing this code include:

• Check payer policy regarding reporting unilateral and bilateral services. Some payers may base payment for global 92136 and the technical component of 92136 (92136–TC) on these services being performed as bilateral procedures.
• For the professional component of 92136 (92136–26), indicate the service is bilateral, such as by appending modifier 50, to ensure accurate reimbursement when documentation supports reporting a bilateral service.
• Code based on the documentation and follow the coding rules that apply to your claim.

8. Historical information

CPT 92136 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates to the code since its addition.

9. Similar codes to CPT 92136

Five similar codes to CPT 92136 and how they differentiate from CPT 92136 are:

• CPT 92133: This code is used for scanning computerized ophthalmic diagnostic imaging of the optic nerve, which is different from the biometry measurements taken in CPT 92136.
• CPT 92134: This code is used for scanning computerized ophthalmic diagnostic imaging of the retina, which is not the focus of CPT 92136.
• CPT 92025: This code is used for corneal topography, which measures the curvature of the cornea, while CPT 92136 measures multiple aspects of the eye for intraocular lens power calculation.
• CPT 92060: This code is used for sensorimotor examination, which assesses eye movement and alignment, unlike the biometry measurements in CPT 92136.
• CPT 92081: This code is used for visual field examination, which evaluates the patient’s peripheral vision, while CPT 92136 focuses on measurements for intraocular lens power calculation.

10. Examples

Here are 10 detailed examples of CPT code 92136 procedures:

1. A patient with a cataract in their right eye requires intraocular lens power calculation prior to cataract surgery. The provider performs ophthalmic biometry by partial coherence interferometry and calculates the appropriate IOL power for the patient.
2. A patient with lens dislocation in both eyes requires IOL power calculation before lens replacement surgery. The provider uses CPT 92136 to perform biometry measurements and calculate the IOL power for both eyes.
3. A patient with a history of high myopia is scheduled for cataract surgery in their left eye. The provider performs ophthalmic biometry by partial coherence interferometry to determine the appropriate IOL power for the patient’s left eye.
4. A patient with a dense cataract in their right eye requires IOL power calculation before cataract surgery. The provider uses CPT 92136 to perform the necessary biometry measurements and calculate the IOL power.
5. A patient with a history of glaucoma and cataracts in both eyes requires IOL power calculation prior to cataract surgery. The provider performs ophthalmic biometry by partial coherence interferometry for both eyes and calculates the appropriate IOL power.
6. A patient with a cataract in their left eye and a history of corneal transplant requires IOL power calculation before cataract surgery. The provider uses CPT 92136 to perform biometry measurements and calculate the IOL power for the patient’s left eye.
7. A patient with a cataract in their right eye and a history of retinal detachment requires IOL power calculation prior to cataract surgery. The provider performs ophthalmic biometry by partial coherence interferometry and calculates the appropriate IOL power for the patient’s right eye.
8. A patient with a cataract in their left eye and a history of uveitis requires IOL power calculation before cataract surgery. The provider uses CPT 92136 to perform the necessary biometry measurements and calculate the IOL power for the patient’s left eye.
9. A patient with a cataract in their right eye and a history of ocular trauma requires IOL power calculation prior to cataract surgery. The provider performs ophthalmic biometry by partial coherence interferometry and calculates the appropriate IOL power for the patient’s right eye.
10. A patient with a cataract in their left eye and a history of macular degeneration requires IOL power calculation before cataract surgery. The provider uses CPT 92136 to perform biometry measurements and calculate the IOL power for the patient’s left eye.