2019 CPT Code Changes – Review of Ophthalmology

The new Current Procedural Terminology (CPT) Category I codes effective for use on January 1, 2019 have been released. However, until those codes become “active,” they aren’t available to use and any instructions or guidelines for previous codes remain in effect. That’s important to know when you or a payer review your claims for compliance and documentation, since the actual date on which an event occurred drives appropriate coding. The same applies to the ICD-10 codes that undergo changes over time. You must follow the guidelines in effect for that date-of-service.

Let’s review the new 2019 CPT codes that are likely to appear in eye care and some of the important things to know about them.

This article addresses the following questions:

  • What are the new CPT codes for January 1, 2019?
  • I’ve heard that some codes were released midyear (for use on claims for July 1, 2018 and afterwards). If so, what are those codes?
  • There are a number of electroretinography code changes. Does CPT give any special instructions related to their use?
  • Why can’t I continue to use CPT 92285 when I take a meibomian gland image?
  • I’ve never heard of macular pigment optical density measurement. What does that refer to?
  • Do we know what the new code “bundles” are yet?
  • What about reimbursement under Medicare for the new codes?

This article was published in Review of Ophthalmology’s Medicare Q & A column, which is written by Corcoran’s Senior Consultant, Paul M. Larson, MBA, MMSc, COMT, COE, CPC, CPMA. To view the entire article in Review of Ophthalmology, click on the link below:


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