Billing and Coding: Ophthalmic Biometry for Intraocular Lens Power Calculation

Medicare Part B covers ophthalmic biometry CPT 76519 (A-scan) and CPT 92136 (optical coherence) for intraocular lens power calculation with specific place-of-service rules for global, technical, and professional components. Billing is limited such that the same provider/group should not bill both modalities or repeat the technical/interpretation components for the same patient within a 12-month period (unless significant change in vision), and appropriate modifiers, ICD-10 diagnosis codes, and ABN procedures must be documented on the claim.

"Ophthalmic biometry using CPT 76519 (A-scan) or CPT 92136 (optical coherence biometry) is payable under Medicare Part B when performed for intraocular lens (IOL) power calculation."

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