Optometric Procedure Codes

Evaluation and Management Codes

Procedure Code 

Modifier

Description

92285   External Ocular Photography with medical diagnostic evaluation for documentation of medical progress (e.g., close-up photography, slit lamp photography, goniophotography, stereo-photography)
92285  26 External Ocular Photography with Medical Diagnostic Evaluation for Documentation of Medical Progress (e.g., Close-Up Photography, Slit Lamp Photography, Goniophotography, Stereo-Photography) 
92285  TC External Ocular Photography with Medical Diagnostic Evaluation for Documentation of Medical Progress (e.g., Close-Up Photography, Slit Lamp Photography, Goniophotography, Stereo-Photography) 
92286   Special Anterior Segment Photography with Medical Diagnostic Evaluation; with Specular Endothelial Microscopy and Cell Count
92286  26 Special Anterior Segment Photography with Medical Diagnostic Evaluation; with Specular Endothelial Microscopy and Cell Count
92286  TC Special Anterior Segment Photography with Medical Diagnostic Evaluation; with Specular Endothelial Microscopy and Cell Count
92310   Prescription of Optical and Physical Characteristics of and Fitting of Contact Lens, with Medical Supervision of Adaptation; Corneal Lens, Both Eyes, Except for Aphakia
92310*+  52 Prescription of Optical and Physical Characteristics of and Fitting of Contact Lens, with Medical Supervision of Adaptation; Corneal Lens, Both Eyes, Except for Aphakia
92311*   Prescription of Optical and Physical Characteristics of and Fitting of Contact Lens, with Medical Supervision of Adaptation; Corneal Lens, for Aphakia, One Eye
92312*   Prescription of Optical and Physical Characteristics of and Fitting of Contact Lens, with Medical Supervision of Adaptation; Corneal Lens, for Aphakia, Both Eyes
92313*   Prescription of Optical and Physical Characteristics of and Fitting of Contact Lens, with Medical Supervision of Adaptation; Corneoscleral Lens
92314* ++   Prescription of Optical and Physical Characteristics of Contact Lens, with Medical Supervision of Adaptation and Direction of Fitting by Independent Technician; Corneal Lens, Both Eyes, Except for Aphakia  
92315* ++   Prescription of Optical and Physical Characteristics of Contact Lens, with Medical Supervision of Adaptation and Direction of Fitting by Independent Technician; Corneal Lens, One Eye, for Aphakia
92316* ++   Prescription of Optical and Physical Characteristics of Contact Lens, with Medical Supervision of Adaptation and Direction of Fitting by Independent Technician; Corneal Lens, Both Eyes, for Aphakia 
92317* ++   Prescription of Optical and Physical Characteristics of Contact Lens, with Medical Supervision of Adaptation and Direction of Fitting by Independent Technician; Corneoscleral Lens
92326*   Replacement of Contact Lens
92330   Prescription, Fitting, and Supply of Ocular Prosthesis, with Medical Supervision of Adaptation
92335* ++   Prescription of Ocular Prosthesis and Direction of Fitting and Supply by Independent Technician, with Medical Supervision of Adaptation
92340   Fitting of Spectacles, Except for Aphakia; Monofocal
92341   Fitting of Spectacles, Except for Aphakia; Bifocal
92342   Fitting of Spectacles, Except for Aphakia; Multifocal, Other Than Bifocal 
92352   Fitting of Spectacle Prosthesis for Aphakia; Monofocal
92353   Fitting of Spectacle Prosthesis for Aphakia; Multifocal
92370   Repair and Refitting Spectacles; Except for Aphakia
92371   Repair and Refitting Spectacles; Special Prosthesis for Aphakia
92390*   Supply of Spectacles, Except Prosthesis for Aphakia and Low Vision Aids
92392   Supply of Low Vision Aids (A Low Vision Aid is Any Lens or Device Used to Aid or Improve Visual Function in a Person Whose Vision Cannot Be Normalized by Conventional Spectacle Correction. Includes Reading Additions Up to 4d.)
99201   Office or Other Outpatient Visit for the Evaluation and Management of a New Patient, Which Requires These Three Key Components: A Problem Focused History; A Problem Focused Examination; and Straightforward Medical Decision Making
99202   Office or Other Outpatient Visit for the Evaluation and Management of a New Patient, Which Requires These Three Key Components: An Expanded Problem Focused History; An Expanded Problem Focused Examination; and Straightforward Medical Decision Making.

99203

  Office or Other Outpatient Visit for the Evaluation and Management of a New Patient, Which Requires These Three Key Components: A Detailed History; A Detailed Examination; and Medical Decision Making of Low Complexity.
99204   Office or Other Outpatient Visit for the Evaluation and Management of a New Patient, Which Requires These Three Key Components: A Comprehensive History; A Comprehensive Examination; and Medical Decision Making of Moderate Complexity.
99205   Office or Other Outpatient Visit for the Evaluation and Management of a New Patient, Which Requires These Three Key Components: A Comprehensive History; A Comprehensive Examination; and Medical Decision Making of High Complexity.  
99212   Office or Other Outpatient Visit for the Evaluation and Management of an Established Patient, Which Requires at Least Two of These Three Key Components: A Problem Focused History; A Problem Focused Examination; Straightforward Medical Decision Making
99213    Office or Other Outpatient Visit for the Evaluation and Management of an Established Patient, Which Requires at Least Two of These Three Key Components: An Expanded Problem Focused History; An Expanded Problem Focused Examination; Medical Decision Making.
99214    Office or Other Outpatient Visit for the Evaluation and Management of an Established Patient, Which Requires at Least Two of These Three Key Components: A Detailed History; A Detailed Examination; and Medical Decision Making of Moderate Complexity.  
99215   Office or Other Outpatient Visit for the Evaluation and Management of An Established Patient, Which Requires at Least Two of These Three Key Components: A Comprehensive History; A Comprehensive Examination; and Medical Decision Making of High Complexity.

* Prior Authorization required for this procedure.
++ Massachusetts provider only may bill for this procedure.