Prepayment Reviews of Ophthalmic Tests

Published on: 4/13/2012

Ophthalmic Diagnostic Tests are to be the subject of prepayment review for Palmetto Medicare.  The reviews will be conducted in Jurisdiction 11, including providers in North Carolina, South Carolina, Virginia and West Virginia.   The focus of the reviews will be:

 

·   76514

Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral determination of corneal thickness

·   92002

Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program: intermediate, new patient

·   92004

Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program: 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

·   92014

Ophthalmological services: medical examination and evaluation with initiation or continuation of diagnostic and treatment program: comprehensive, established patient, one or more visits

·   92015

Determination of refractive state

·   92020

Gonioscopy, separate procedure

·   92083

Visual field examination unilateral or bilateral, with interpretation and report: extended examination (e.g., Goldman Visual Fields with at least three quantitative, automated threshold perimetry, Octopus Program G-1, 32 or 42, Humphrey Visual Field ANA

·   92225

Ophthalmoscopy, extended with retinal drawing (e.g., for retinal detachment, melanoma) with interpretation and report: initial

·   92226

Ophthalmoscopy, extended with retinal drawing (e.g., for retinal detachment, melanoma) with interpretation and report: subsequent

·   92235

Fluorescein Angiography (Includes multiframe imaging) with interpretation and report

·   92250

Fundus photography with interpretation and report

·   92285

External ocular photography with interpretation and report for documentation of medical progress (e.g., close-up photography, slit lamp photography, goniophotography, stereo-photography)

 

The complete text of this announcement, including instructions for preparing and sending the documents can be obtained from the Palmetto website at http://www.palmettogba.com/palmetto/providers.nsf/ls/jurisdiction%2011%20part%20b~8t9nz80035?opendocument&utm_source=j11bl&utm_campaign=j11bls&utm_medium=email