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The diagnostic dark adaptation examination, represented by CPT® Code 92284, is a specialized test designed to evaluate the ability of the eyes to recover sensitivity in low-light conditions after being exposed to bright light. This examination is crucial for understanding how well the eyes can transition from bright to dark environments, a process primarily mediated by two types of photoreceptor cells in the retina: cone cells and rod cells. Cone cells are responsible for vision in well-lit conditions, while rod cells are essential for vision in dim light. The transition from cone-mediated vision to rod-mediated vision does not occur instantaneously; it can take up to 50 minutes for the eyes to fully adapt to darkness, depending on the intensity of the initial light exposure and the duration of that exposure. During the dark adaptation test, the patient is first subjected to bright light for approximately five minutes. Following this exposure, the light source is turned off, and the examination measures the time required for the eyes to adapt to the dark environment and achieve peak dark vision. This is accomplished by presenting the patient with flashes of light at varying intensities in the newly darkened setting. The patient is instructed to indicate whether they can see each flash. If the patient cannot perceive a flash, a higher intensity flash is presented until visibility is confirmed. The intensity of the flashes is then gradually decreased to identify the lowest light level that the patient can detect during the adaptation process. The duration taken to reach this threshold of visibility is recorded as the dark adaptation time. The results of the examination are typically represented graphically, accompanied by a written interpretation of the findings, which provides valuable insights into the patient's visual function in low-light conditions.
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The diagnostic dark adaptation examination is indicated for various conditions and symptoms that may affect a patient's ability to see in low-light environments. The following are explicitly provided indications for this procedure:
The procedure for conducting a diagnostic dark adaptation examination involves several key steps that are meticulously followed to ensure accurate results. The following procedural steps are outlined:
After the completion of the diagnostic dark adaptation examination, there are typically no specific post-procedure care requirements. Patients may resume their normal activities immediately following the test. However, it is important for healthcare providers to review the results with the patient, discussing any findings that may indicate underlying visual issues. The graphical representation of the results, along with the written interpretation, serves as a valuable tool for further evaluation and potential treatment options if necessary. Continuous monitoring of the patient's visual function may be recommended based on the outcomes of the examination.
| Short Descr | DX DARK ADAPTATION EXAM I&R | Medium Descr | DX DARK ADAPTATION EXAM INTERPRETATION & REPORT | Long Descr | Diagnostic dark adaptation examination with interpretation and report | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 3 - Technical Component Only Code | Multiple Procedures (51) | 7 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic ophthalmology services apply... | Bilateral Surgery (50) | 2 - 150% payment adjustment does NOT apply. | Physician Supervisions | 01 - Procedure must be performed under the general supervision of a physician. | 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 | STV-Packaged Codes | 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 |
| 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). | 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. | 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) | GA | Waiver of liability statement issued as required by payer policy, individual case | 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). | 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. | 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.) | E2 | Lower left, eyelid | 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 | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2023-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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