2025 CPT code 92133

Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve.

This code represents the global service, including both the professional and technical components. If billing separately, use modifier 26 for the professional component and TC for the technical component (unless the hospital provided the technical component, in which case TC is not appended). Do not use modifiers 26 or TC when billing for the global service.

Modifiers 26 and TC can be applied if billing for the professional or technical component separately. Modifiers such as 51, 52, 79, 80, 81, 82, AS, PD, Q6 may also be applicable depending on the specific circumstances.

Medical necessity must be established for the performance of 92133. The documentation should clearly indicate the clinical rationale for performing the test, linking it to the patient's signs, symptoms, or diagnosis.

In simple words: The doctor uses a special camera to take detailed pictures of the back of your eye, focusing on the optic nerve.This helps them check for eye diseases.The doctor reviews the pictures and provides a report.

This code represents scanning computerized ophthalmic diagnostic imaging (SCODI) of the posterior segment of the eye, specifically focusing on the optic nerve. It includes interpretation and report generation, and can be performed on one or both eyes.The procedure involves the use of technology like optical coherence tomography (OCT) to create detailed images of the optic nerve. The provider marks the edge of the optic nerve using a computer pointing device and interprets the images to diagnose and manage potential diseases of the visual system.

Example 1: A patient with a history of glaucoma presents with new vision changes. 92133 is performed to assess the optic nerve for any changes or damage related to the glaucoma., A patient experiences sudden vision loss. 92133 is used to evaluate the optic nerve for signs of optic neuritis or other causes of vision loss., A patient with diabetes undergoes regular eye exams. 92133 is performed to monitor the optic nerve for any diabetic retinopathy changes.

Documentation must support the medical necessity of the procedure. It should include patient history, symptoms, examination findings, and the reason for performing the SCODI of the optic nerve. Images and the interpretation report should be included in the patient's medical record.

  • Modifier TC rule: Modifier TC is applicable when billing for only the technical component, unless provided by the hospital.
  • Specialties:Ophthalmology
  • Place of Service:Office (11), Nursing Facility (32 - for Medicare patient not in a Part A stay), Independent Clinic (49)
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