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Official Description

Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Serial tonometry, as defined by CPT® Code 92100, is a diagnostic procedure utilized to measure the intraocular pressure (IOP) within the eye. This procedure is particularly significant in the evaluation and management of conditions such as glaucoma, where monitoring IOP is crucial for assessing the risk of optic nerve damage. The process involves taking multiple measurements of the intraocular pressure over an extended time period, typically within the same day, to create a comprehensive profile of pressure fluctuations, often referred to as a diurnal curve. This curve helps in identifying peak pressures and acute elevations that may require medical intervention. Various techniques are employed in serial tonometry, including Goldmann's tonometry, which is the most widely accepted method. This technique involves flattening a specific area of the cornea while applying a known force to measure the pressure. Other methods include applanation tonometry, which requires the use of a topical anesthetic and a disinfected prism to accurately gauge pressure, and Perkins tonometry, a portable option suitable for children or patients who cannot be examined using a slit lamp. Each method provides valuable insights into the intraocular pressure dynamics, aiding healthcare professionals in making informed decisions regarding treatment and management of ocular conditions.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Serial tonometry is indicated for the assessment of intraocular pressure in various clinical scenarios. The following conditions and situations warrant the use of this procedure:

  • Glaucoma Diagnosis - Serial tonometry is essential in diagnosing glaucoma, a condition characterized by increased intraocular pressure that can lead to optic nerve damage.
  • Monitoring of Intraocular Pressure - This procedure is used to monitor patients with known elevated intraocular pressure or those undergoing treatment for conditions that may affect IOP.
  • Acute Elevation of Intraocular Pressure - Serial tonometry is performed in cases of acute elevation of intraocular pressure to determine the need for immediate medical intervention.
  • Assessment of Treatment Efficacy - The procedure helps evaluate the effectiveness of medical treatments aimed at lowering intraocular pressure.

2. Procedure

The procedure of serial tonometry involves several key steps to ensure accurate measurement of intraocular pressure. Each step is critical for obtaining reliable data:

  • Preparation - The patient is prepared for the procedure, which may include the administration of a topical anesthetic to minimize discomfort during the measurement process.
  • Measurement Technique - Multiple measurements of intraocular pressure are taken using one of the established tonometry methods, such as Goldmann's, applanation, or Perkins tonometry. The choice of method may depend on the patient's condition and the clinician's preference.
  • Data Collection - Measurements are recorded at various intervals throughout the day to capture fluctuations in intraocular pressure, creating a diurnal curve that reflects the pressure changes over time.
  • Interpretation and Reporting - After completing the measurements, the collected data is analyzed, and a report is generated that includes the findings and any recommendations for further management or treatment.

3. Post-Procedure

Following the procedure, patients may be monitored for any immediate side effects related to the anesthetic used or the tonometry itself. It is important to provide patients with information regarding the significance of the results obtained from the serial tonometry. Depending on the findings, further evaluation or treatment may be necessary. Patients should be advised to follow up with their healthcare provider to discuss the results and any potential next steps in their management plan.

Short Descr SERIAL TONOMETRY
Medium Descr SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRS
Long Descr Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)
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) Q - Vision Items or Services
Berenson-Eggers TOS (BETOS) M5C - Specialist - ophthalmology
MUE 1
CCS Clinical Classification 220 - Ophthalmologic and otologic diagnosis and treatment
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.
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
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)
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.
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
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.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Date
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2024-01-01 Changed Short and Medium Descriptions changed.
Pre-1990 Added Code added.
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