CPT code 92132 is for computerized ophthalmic diagnostic imaging of the anterior segment of the eye.
CPT code 92132 is used to bill for computerized ophthalmic diagnostic imaging of the anterior segment of the eye. This procedure typically involves the use of advanced imaging technology to capture detailed images of the front part of the eye, including the cornea, iris, and lens. This is crucial for diagnosing and managing various eye conditions such as glaucoma, corneal disorders, and cataracts.
For CPT code 92132 (Computerized ophthalmic diagnostic imaging, anterior segment), the application of modifiers can be essential depending on the specific billing circumstances and payer requirements. Here is an ordered list of common modifiers that might be used with this code and the reasons for each:
1. -26 Professional Component: Used when only the professional component (interpretation and report) of the service is performed, and not the technical component.
2. -TC Technical Component: Applied when only the technical component (equipment, supplies, and technical staff) of the service is provided, without the professional interpretation.
3. -LT Left Side: Indicates that the service was performed on the left eye.
4. -RT Right Side: Indicates that the service was performed on the right eye.
5. -50 Bilateral Procedure: Used when the procedure is performed on both eyes during the same session.
6. -59 Distinct Procedural Service: This modifier is used to indicate that the service is distinct or independent from other services performed on the same day.
7. -76 Repeat Procedure by Same Physician: Used if the procedure is repeated by the same physician on the same day.
8. -77 Repeat Procedure by Another Physician: Applied when the procedure is repeated by a different physician on the same day.
9. -91 Repeat Clinical Diagnostic Laboratory Test: In the rare case that this code is used in a diagnostic lab setting and the test needs to be repeated.
Each modifier has specific billing implications and should be used accurately to convey the correct circumstances under which the service was provided, ensuring appropriate reimbursement and compliance with payer policies.
CPT code 92132, which refers to computerized ophthalmic diagnostic imaging of the anterior segment, is generally reimbursed by Medicare. This code is commonly used for procedures involving imaging techniques like anterior segment optical coherence tomography (OCT).
The reimbursement for CPT code 92132 can vary based on geographic location and the specific Medicare Administrative Contractor (MAC) policies. However, as a general guideline, the Medicare Physician Fee Schedule (MPFS) provides a base payment rate. For instance, in 2023, the national average reimbursement rate for this code might be approximately $40 to $50, though this amount can differ significantly depending on the locality adjustments.
Healthcare providers should verify the specific reimbursement rates and any applicable adjustments or bundling rules with their local MAC to ensure accurate billing and reimbursement for services rendered under CPT code 92132. Additionally, it's important to ensure that the documentation supports the medical necessity of the procedure to facilitate appropriate Medicare reimbursement.
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