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2025 CPT code 99174

Instrument-based ocular screening (e.g., photoscreening, automated-refraction), bilateral; with remote analysis and report.

Modifiers applicable to this code include 33, 52, 53, 59, 76, 77, 79, 99, CR, ET, GA, GC, GJ, GR, GY, GZ, KX, Q5, Q6, QJ, XE, XP, XS, and XU.

Medical necessity should be documented based on factors such as age, family history, symptoms, or other risk factors indicating the need for vision screening.

IMPORTANT Do not report 99174 in conjunction with 92002-92014, 99172, 99173, 99177.

In simple words: A vision screening test is conducted on both eyes using special instruments. The results are analyzed remotely, and a report is provided.

This code represents an instrument-based ocular screening procedure performed on both eyes. It includes remote analysis of the results and a report.The procedure may involve methods like photoscreening or automated refraction.

Example 1: A 2-year-old child with a family history of amblyopia (lazy eye) undergoes instrument-based vision screening using photoscreening during a well-child visit. , A pediatrician performs automated refraction on both eyes of a school-aged child during a routine check-up., A mobile vision screening unit visits a community center and conducts instrument-based ocular screenings on adults to detect potential eye problems.

Documentation should include the type of instrument used, laterality (both eyes specified), the results of the screening, the interpretation and report, and any relevant medical history or risk factors for eye disease.

** This service is often not covered by Medicare but may be covered by other payers. It is important to check payer guidelines before billing this code.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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