Anyone know what's up with HCFA CPT4 #92081 ???

[Pete Hanlin]

In looking through the 2002 Medicare Part B payment listings, I note that 92081 (a limited visual field screening) is reimbursed at $76.63, while 92082 and 92083 (which are more extensive visual field procedures) are listed as $45.55 and $70.27 respectively.

What's the deal? Is this a typo, or is Medicare really wanting to pay more for a lower service? Is this some kind of evil trick to see if ODs will downcode to the better reimbursed code?

Thanks for the info!

[NC-OD]

Hey Pete,

I heard it was an absolute goof-up on Medicare's part (surprise, surprise). I believe they are working to correct it.........

[stephanie]

Gee that is the first I heard of that...mostly we only use 92083 anyway. I hope they fix it. Almost all my pts are on Medicare!!

Steph

[Tammy]

This was published in the AOA NEWS, January 28, 2002....Review prompts changes to some CPT code values.....

Special ophthalmological services (CPT 92081,92082,and 92083) CMS officals acknowledged they could not entirely explain substantial decreases in the value for the codes. Exam lanes were removed as an expense for all three codes.

Supplies were completely removed from 92082. Howerver, those factors may not be sufficient to account for changes in values and an apparent anomaly in the rank order of the codes, officials said. CMS staff promised to review the value changes further.

I hope this helps all of you, it was a very good read for me, only because of what I do, I had TONS of telephone calls when the new fee schedule came out in December. If your doc's are AOA members ask to see it, or try to access it on their web site.

www.aoa.org

Your friend in the billing department,

Tammy