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Ophthalmic Coding Specialist Study Questions

Category - Opthalmological Coding Certification Practice Test

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Mr. Longoria, a patient with an established cataract, was displeased with his current ophthalmologist so today he was seen by a new physician. The ophthalmologist performed an ophthalmoscopy and tonometry on Mr. Longoria, as well as an external examination of both eyes and a review of the patient’s interval history. What is the correct code for Mr. Longoria’s ophthalmology service today?
  1. 92002
  2. 92004
  3. 92012
  4. 92014
Explanation
Answer: A - The correct code for Mr. Longoria’s ophthalmology service today is with 92002, (Ophthalmological Services; Medical Examination and Evaluation with Initiation of Diagnostic and Treatment Program; Intermediate, New Patient. Codes 92012 and 92014 are incorrect because they are used for established patients. In this case, the patient is new to this physician and the correct level of evaluation is intermediate because the patient has an established (known) cataract. The patient’s cataract is not newly diagnosed. Furthermore, the patient did not receive a comprehensive examination.
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