Billing and Coding: Visual Electrophysiology Testing

This billing and coding guideline complements the LCD for visual electrophysiology testing and clarifies that procedure codes may be subject to NCCI and OPPS edits which should be checked before billing. Claims must include a valid, specific ICD-10-CM diagnosis code or they will be returned under Section 1833(e), and, where applicable, the referring/ordering physician's name and NPI must be reported on the claim.

"Procedure codes for visual electrophysiology testing may be subject to NCCI edits or OPPS packaging edits and may be denied, bundled, or adjusted; verify applicable NCCI and OPPS edits before billi..."

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