Billing and Coding: Visual Fields Testing

Medicare coverage for visual fields testing requires appropriate ICD-10 diagnosis coding and medical-record documentation that fully supports medical necessity (including history, physical exam, and pertinent test results) in accordance with the applicable LCD. Claims must include the referring/ordering physician's name and NPI when required, and procedure codes may be subject to NCCI and OPPS edits that can affect billing or payment.

"A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act."

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