How To Use CPT Code 99172

CPT 99172 describes the visual function screening procedure used to determine a patient’s visual acuity, ocular alignment, color vision, and field of vision. 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 99172?

CPT 99172 can be used to describe the visual function screening procedure performed by a provider other than an ophthalmologist or optometrist. This code is used to assess various aspects of visual function, including visual acuity, ocular alignment, color vision, and field of vision. The provider uses automated or semi-automated devices to determine if the patient’s visual function is sufficient for their job duties.

2. Official Description

The official description of CPT code 99172 is: ‘Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision (may include all or some screening of the determination[s] for contrast sensitivity, vision under glare). This service must employ graduated visual acuity stimuli that allow a quantitative determination of visual acuity (e.g., Snellen chart). This service may not be used in addition to a general ophthalmological service or an E/M service. Do not report 99172 in conjunction with 99173, 99174, 99177, 0469T.’

3. Procedure

1. The provider conducts a visual function screening using automated or semi-automated devices.
2. The patient is positioned in front of a lightbox with a standard Snellen’s visual testing chart.
3. The provider asks the patient to read the letters on the chart, assessing their visual acuity.
4. The provider examines the patient’s ocular alignment by observing the appearance of the eyes and performing a Hirschberg test.
5. The provider may also assess the patient’s field of vision by showing objects at various points in their field of view.
6. Color vision is evaluated using pseudoisochromatic plates, where the patient identifies hidden shapes or numbers.
7. Based on the results of the screening, the provider determines if further evaluation is necessary.

4. Qualifying circumstances

CPT 99172 is used for patients who require a visual function screening to assess their ability to perform job duties that rely on sharp visual acuity. This code is not reported by ophthalmologists or optometrists but by providers such as occupational specialists. The screening evaluates visual acuity, ocular alignment, color vision, and field of vision using automated or semi-automated devices.

5. When to use CPT code 99172

CPT code 99172 should be used when a provider other than an ophthalmologist or optometrist performs a visual function screening to determine if a patient’s visual function is sufficient for their job duties. This code should not be reported in conjunction with an E/M code or another ophthalmology code.

6. Documentation requirements

To support a claim for CPT 99172, the provider must document the following information:

• Patient’s need for a visual function screening
• Specific devices used for the screening
• Date and time of the screening
• Results of the screening, including visual acuity, ocular alignment, color vision, and field of vision
• Any further evaluation or treatment recommended
• Signature of the provider performing the screening

7. Billing guidelines

When billing for CPT 99172, ensure that the provider performing the screening is not an ophthalmologist or optometrist. This code should not be reported in conjunction with an E/M code or another ophthalmology code. It is important to note that just because the word ‘visual’ is in the CPT descriptor, it does not mean the code is specific to ophthalmology. Providers such as occupational specialists who screen patients for job-related visual acuity should use this code.

8. Historical information

CPT 99172 was added to the Current Procedural Terminology system on January 1, 2001. There have been no updates or changes to the code since its addition.

9. Examples

1. An occupational specialist performing a visual function screening for a pilot to assess their visual acuity, ocular alignment, color vision, and field of vision.
2. A provider conducting a visual function screening for a patient applying for a job that requires sharp visual acuity.
3. An occupational therapist performing a visual function screening for a patient who needs to meet specific visual requirements for their job.
4. A provider evaluating a patient’s visual function to determine if they are eligible for a certain job position.
5. An occupational specialist conducting a visual function screening for a patient who needs to pass a visual acuity test for their job.
6. A provider performing a visual function screening for a patient who wants to become a commercial driver.
7. An occupational therapist assessing a patient’s visual acuity, ocular alignment, color vision, and field of vision to determine their eligibility for a job in law enforcement.
8. A provider conducting a visual function screening for a patient who needs to meet specific visual requirements for their job as a firefighter.
9. An occupational specialist evaluating a patient’s visual function to determine if they can perform the visual tasks required for their job as a surgeon.
10. A provider performing a visual function screening for a patient who wants to become a professional athlete and needs to meet certain visual acuity standards.