ODs: Use new pupillometry code now

For the first time, the American Medical Association (AMA) has released a Current Procedural Terminology (CPT) code for pupillometry.

The code is as follows: 0341T—Quantitative pupillometry with interpretation and report, unilateral or bilateral.

Eye care practitioners can begin using this new Category III temporary CPT code on insurance claims immediately. It took effect Jan. 1, 2014.

Code reflects increased use of pupillometry

Once considered esoteric, pupillometry—the measurement of pupil size—is being used more widely for assessing laser refractive correction patients. Recent studies demonstrate the relationship between pupil responses and early signs of Parkinson's, Alzheimer's, autism, cardiovascular disease and other systemic rheumatologies.

Pupillometry is currently not covered by most medical or vision insurance plans. However, reporting the procedure on claims is an important step toward eventually securing third-party reimbursement for the procedure, said Doug Morrow, O.D., of the AOA Third Party Center (TPC) Executive Committee.

For this reason, the AOA TPC encourages all optometrists to report pupillometry using the new 0341T code on claims.

The AMA generally issues Category III temporary CPT codes—designated with a "T"—as the first step toward developing a permanent code for procedures. Data collected through use of the temporary code will help determine if a permanent code is warranted.

The new temporary code does not appear on the AMA's official CPT roster for 2014. However, it is valid and accepted for use.

A full list of new and revised CPT codes is available in AOA News' special issue devoted to health care reform

Do you have a coding or billing question? Ask the Codeheads.

January 13, 2014

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