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The CPT® Code 92072 refers to the fitting of contact lenses specifically for the management of keratoconus, marking the initial fitting process. Keratoconus is a progressive eye condition characterized by the thinning and conical deformation of the cornea, which leads to visual distortions and blurred vision. The fitting of contact lenses in this context is not aimed at correcting vision in the traditional sense but rather at managing the symptoms and effects of this condition. During the fitting process, the practitioner provides comprehensive instructions to the patient regarding the use and care of the lenses, ensuring that the wearer is adequately trained to handle the lenses safely and effectively. The procedure encompasses the supply of the contact lenses and includes any incidental adjustments that may be necessary during the fitting and training phases. It is important to note that the fitting process is tailored to the unique characteristics of the patient's cornea, which is assessed through corneal topography studies. The selection of the appropriate lens type is crucial, as various lens options are available to accommodate the specific needs of individuals with keratoconus. The fitting process may involve multiple trials with different lenses to achieve the optimal fit, ensuring that the lens provides adequate coverage and comfort while minimizing movement on the eye. This meticulous approach is essential for managing the condition effectively and improving the patient's quality of vision.
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The fitting of contact lenses for the management of keratoconus, as described by CPT® Code 92072, is indicated for patients diagnosed with this progressive eye condition. The following conditions and symptoms warrant the procedure:
The procedure for the initial fitting of contact lenses for keratoconus involves several critical steps to ensure the lenses are appropriately selected and fitted for the patient.
After the initial fitting of contact lenses for keratoconus, patients are typically provided with instructions on how to care for and use their lenses properly. It is essential for patients to follow these guidelines to maintain eye health and ensure the longevity of the lenses. Follow-up appointments may be scheduled to monitor the fit and comfort of the lenses, as well as to make any necessary adjustments. Patients should also be advised to report any discomfort, vision changes, or complications that may arise during the use of the lenses, as timely intervention can help prevent further issues.
| Short Descr | FITG C-LENS KERATOCONUS 1ST | Medium Descr | FITTING CONTACT LENS FOR MGMT OF KERATOCONUS 1ST | Long Descr | Fitting of contact lens for management of keratoconus, initial fitting | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 2 - 150% payment adjustment does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | M5C - Specialist - ophthalmology | MUE | 1 | CCS Clinical Classification | 220 - Ophthalmologic and otologic diagnosis and treatment |
| LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 24 | Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | KX | Requirements specified in the medical policy have been met | SC | Medically necessary service or supply | TG | Complex/high tech level of care |
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| 2024-01-01 | Changed | Short and Medium Descriptions changed. |
| 2012-01-01 | Added | Added |
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