New Category III codes

New Category III codes

Ask the Coding Experts, by Doug Morrow, O.D., Harvey Richman, O.D., and Rebecca Wartman, O.D.

One of the hottest discussions in therapeutic eye care is dry eye. This has fostered increased use of over-the-counter and prescription medications for the management of the condition. There also has been a growth in the evaluation mechanisms for this condition. Recently, higher-level technology has been developed to further quantify the mechanism and severity of dry eye in patients.

To meet certain evolving technology, the American Medical Association's Current Procedural Terminology (CPT®) team created a Category III code. A Category III code is usually not reimbursable by third-party payers, but the filing of the charges allows the CPT editorial panel to gauge the frequency of use, which will give the editorial panel necessary information to base their decision to move the code to Category I status. Therefore, it's important to bill the patient and submit to the insurance carrier. This is one example of when an Advanced Beneficiary Notification could be used.

CPT Category III code 0330T was created in 2014 to report digital interferometry, an eye tear film-imaging method used to assess the lipid layer of the tear film of the eye in order to measure the thickness of the layer. The thickness of the lipid layer is important because, if it is compromised or inadequate, the production of tears may be affected, resulting in what is commonly known as dry eye (e.g., evaporative dry eye or lipid-deficient dry eye). The lipid layer is responsible for minimizing evaporation of the inner layers of the tear film, therefore keeping eyes lubricated and clear of debris.

Category III code 0330T is reported when tear film imaging is performed unilaterally or bilaterally, and requires interpretation and report as part of the services provided. Digital interferometry includes interferogram color assessment of the tear film. This color assessment is performed using a camera to distribute illuminating light across the cornea while blinking. The findings, captured as a video image, are later converted into a numerical value the physician uses to determine if the patient has a lipid deficiency.

As technology for diagnosis and treatment of ocular disease becomes more advanced, we should continue to see new codes being brought to CPT. Just this past year we saw this code as well as 24-hour intraocular pressure monitoring and pupillometry assessment options. Look for more on these codes in the future.

October 21, 2014

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