CPT CHANGES FOR 2012 – Impact on Contact Lens Fitting


There are a few changes in the CPT coding manual affecting ophthalmology in 2012.  Those changes include:

  • The new and established patient definitions have been revised to include a reference to specialties and subspecialties.  The definition now states that a new patient is one who has not received any professional services from the physician or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.
  • The Integumentary System subsection has been expanded to include new guidelines to clarify reporting of wound care management and skin substitutes.  A new heading was created for Skin Substitutes Graft.
  • A parenthetical phrase was added below code 65775, Corneal wedge resection, to indicate that fitting of contact lens for treatment of disease, should be reported with codes 92071, 92072.
  • Code 92070, Fitting of contact lens for treatment of disease, including supply of lens, has been deleted.
  • Code 92071, Fitting of contact lens for treatment of ocular surface disease.
  • Code 92072, Fitting of contact lens for management of keratoconus, initial fitting.
  • These two new codes were created to replace code 92070.  Report supply of lens separately with code 99070 or appropriate supply code.  As a reminder, Medicare does not pay separately for the lens.
  • Serial Tonometry, code 92100, now includes a parenthetical phrase indicating that ocular blood flow measurements are reported with code 0198T and that single tonometry is a component of an office visit.
  • Codes 92120 and 92130, Tonography, have been deleted due to extreme low use of these services.
  • Code +0289T – Corneal incisions in the donor cornea created using a laser, in preparation for penetrating or lamellar keratoplasty.
  • Code +0290T – Corneal incisions in the recipient cornea created using a laser, in preparation for penetrating or lamellar keratoplasty.
  • The two codes are to be used in conjunction with 65710, 65730, 65750, and 65755.

*Source: Rose & Associates