Guidance on Visual Field Studies prior to Eyelid Surgery
The September 2010 CPT Assistant (Volume 20, Issue 9) provides direction on how to code for visual fields performed prior to eyelid surgery. Visual field studies help support the medical necessity of ptosis repair and blepharoplasty. In order to confirm that surgically raising the eyelids improves visual function, fields are performed with the eyelids at rest and then taped to mimic the expected surgical outcome.
The test required is a single stimulus test (92081) performed twice. CPT Assistant indicates “Code 92081 is designated as a unilateral or bilateral procedure. It is only reported once per session, even when the exam includes evaluations with and without lid taping as in evaluation for blepharoplasty. Therefore, it should be reported once, regardless of whether the examination is performed more than once unilaterally or bilaterally.”
Given this instruction, the use of modifier 76 for repeat service is inappropriate in this situation. Check your local payers for further instructions.