tci Medicare Compliance & Reimbursement - 2010 Issue 17

Reader Questions: Modify Eye Codes Just Like E/M Codes

Question: I just started working in an ophthalmologist's office and I have a question about modifiers. Can we append modifiers 25 or 57 to the eye codes 92002"92014? The descriptions of the modifiers only specify E/M codes -- do the eye codes count? Answer: Medicare and most other carriers treat the eye codes -- 92002 (Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient), 92004 (... comprehensive, new patient, one or more visits), 92012 (Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient)...

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