Two new CPT codes available for use on July 1, 2018

On July 1, new CPT Category III codes became available for use; two of them apply to eye care.  Importantly, they won’t appear in code books until 2019 code books are published, but apply now.

The two codes are as follows:

  • 0506T Macular pigment optical density measurement by heterochromatic flicker photometry, unilateral or bilateral, with interpretation and report
  • 0507T Near-infrared dual imaging (ie, simultaneous reflective and trans-illuminated light) of meibomian glands, unilateral or bilateral, with interpretation and report

(For external ocular photography, use 92285. For tear film imaging, use 0330T)

Both codes have a “sunset” (expiration) of January 1, 2024.

CMS has published some guidance but coverage and reimbursement rates, if any, for Category III codes are determined by the individual Medicare Administrative Contractors (MACs).  We anticipate that these two codes will appear in the “Category III” or “Noncovered” LCDs for your MAC in the near future.  Private payers will very likely regard these as noncovered services since the codes are so new.

We are happy to assist you in any way with other topics including proper code selection, chart reviews and payer actions; we can also provide training on these or other subjects.  Please contact us via one of the below links or on our “App”, Corcoran 24/7, which can be accessed via one of the links below.

 

www.corcoranccg.com   (800) 399-6565

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