ArticleActive
Billing and Coding: Visual Fields Testing
A56799
Effective: November 6, 2025
Updated: December 31, 2025
Policy Summary
Visual field testing is billable to Part A or Part B MAC when reasonable and necessary, supported by a valid ICD-10-CM diagnosis code, and accompanied by appropriate documentation (assessment, medical history, test results, signed visit/operative report). Claims must include ordering/referring physician name and NPI when applicable, comply with NCCI/OPPS edits, and use the proper ABN modifiers (GA, GX, GZ, GY) with Form CMS-R-131 and occurrence code 32 as required; certain modifiers will cause automatic denial on adjudication.
Coverage Criteria Preview
Key requirements from the full policy
"Visual field testing is covered when billed to the Part A or Part B MAC with a valid ICD-10-CM diagnosis code that best describes the patient’s condition and when the service is reasonable and nece..."
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