LCD/NCD Portal

L29006

 

VISUAL FIELD EXAMINATIONS

 

10/01/2011

 

Indications and Limitations of Coverage and/or Medical Necessity

 

Visual field examinations will be considered medically necessary under any of the following conditions:

• The patient has inflammation or disorders of the eyelids potentially affecting the visual field.

• The patient has a documented diagnosis of glaucoma.

o Please note that the stabilization or progression of glaucoma can be monitored only by:

 A visual field examination.

 the frequency of such examinations is dependent on:

• The variability of intraocular pressure measurements (i.e., progressive increases despite treatment indicate a worsening condition).

• The appearance of new hemorrhages.

• Progressive cupping of the optic nerve.

• The patient is a glaucoma suspect as evidenced by an increase in intraocular pressure, asymmetric intraocular measurements of greater than 2-3 mm Hg between the two eyes, or has optic nerves suspicious for glaucoma which may be manifested as:

o Asymmetrical cupping.

o Disc hemorrhage.

o An absent or thinned temporal rim.

• The patient has a documented disorder of the optic nerve, the neurologic visual pathway, or retina.

o Please note that patients with a previously diagnosed retinal detachment do not need a pretreatment visual field examination.

o Additionally, patients with an established diagnosed cataract do not need a follow-up visual field unless other presenting symptomatology is documented.

o In patients who are about to undergo cataract extraction, who do not have glaucoma and are not glaucoma suspects, a visual field would not be indicated.

• The patient has a recent

o Intracranial hemorrhage.

o An intracranial mass.

o A recent measurement of increased intracranial pressure with or without visual symptomatology.

• The patient has a recently documented

o Occlusion or/and stenosis of cerebral and precerebral arteries.

o A recently diagnosed transient cerebral ischemia.

o Giant cell arteritis.

• The patient having an initial workup for

o Buphthalmos.

o Congenital anomalies of the posterior segment.

o Congenital ptosis.

• The patient has inflammation or disorders of the orbit, potentially affecting the visual field.

• The patient has sustained a significant eye injury.

• The patient has an unexplained visual loss which may be described as “trouble seeing or vision going in and out.”

• The patient has a pale or swollen optic nerve documented by a visual exam of recent origin.

• The patient is having some new functional limitations which may be due to visual field loss (i.e., reports by family that patient is running into things).

• The patient is being evaluated initially for macular degeneration or has experienced central vision loss resulting in vision measured at or below 20/70.

o Please note that repeated examinations for a diagnosis of macular degeneration or an experienced central vision loss are not necessary unless changes in vision are documented or to evaluate the results of a surgical intervention.

• Repeat visual field examinations for patients undergoing surgery of the upper eyelid(s) and brow (see LCD L29301 FL part B; L29485 PR/VI part B) are considered reasonable and medically necessary.

o The initial (taped) and repeat (untaped) visual field examination should be performed on the same date of service.

• The patient is receiving or has completed treatment of a high-risk medication that may cause visual side effects, (i.e., a patient on plaquenil may develop retinopathy).

Coding Information

 

Bill Type Codes

• Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service.

• Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type.

• Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

 

 

12x Hospital Inpatient (Medicare Part B only)

13x Hospital Outpatient

14x Hospital - Laboratory Services Provided to Non-patients

21x Skilled Nursing - Inpatient (Including Medicare Part A)

22x Skilled Nursing - Inpatient (Medicare Part B only)

23x Skilled Nursing - Outpatient

85x Critical Access Hospital

 

Revenue Codes

• Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service.

• In most instances Revenue Codes are purely advisory; unless specified in the policy services reported under other Revenue Codes are equally subject to this coverage determination.

• Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.

 

 

0510 Clinic - General Classification

0511 Clinic - Chronic Pain Center

0512 Clinic - Dental Clinic

0513 Clinic - Psychiatric Clinic

0514 Clinic - OB-GYN Clinic

0515 Clinic - Pediatric Clinic

0516 Clinic - Urgent Care Clinic

0517 Clinic - Family Practice Clinic

0519 Clinic - Other Clinic

0920 Other Diagnostic Services - General Classification

 

CPT/HCPCS Codes

 

 

92081 VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; LIMITED EXAMINATION (EG, TANGENT SCREEN, AUTOPLOT, ARC PERIMETER, OR SINGLE STIMULUS LEVEL AUTOMATED TEST, SUCH AS OCTOPUS 3 OR 7 EQUIVALENT)

92082 VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; INTERMEDIATE EXAMINATION (EG, AT LEAST 2 ISOPTERS ON GOLDMANN PERIMETER, OR SEMIQUANTITATIVE, AUTOMATED SUPRATHRESHOLD SCREENING PROGRAM, HUMPHREY SUPRATHRESHOLD AUTOMATIC DIAGNOSTIC TEST, OCTOPUS PROGRAM 33)

92083 VISUAL FIELD EXAMINATION, UNILATERAL OR BILATERAL, WITH INTERPRETATION AND REPORT; EXTENDED EXAMINATION (EG, GOLDMANN VISUAL FIELDS WITH AT LEAST 3 ISOPTERS PLOTTED AND STATIC DETERMINATION WITHIN THE CENTRAL 30¡, OR QUANTITATIVE, AUTOMATED THRESHOLD PERIMETRY, OCTOPUS PROGRAM G-1, 32 OR 42, HUMPHREY VISUAL FIELD ANALYZER FULL THRESHOLD PROGRAMS 30-2, 24-2, OR 30/60-2)

 

 

ICD-9 Codes that Support Medical Necessity

 

 

094.81 SYPHILITIC ENCEPHALITIS

094.82 SYPHILITIC PARKINSONISM

094.83 SYPHILITIC DISSEMINATED RETINOCHOROIDITIS

094.84 SYPHILITIC OPTIC ATROPHY

094.85 SYPHILITIC RETROBULBAR NEURITIS

094.86 SYPHILITIC ACOUSTIC NEURITIS

094.87 SYPHILITIC RUPTURED CEREBRAL ANEURYSM

094.89 OTHER SPECIFIED NEUROSYPHILIS

095.8 OTHER SPECIFIED FORMS OF LATE SYMPTOMATIC SYPHILIS

190.0 MALIGNANT NEOPLASM OF EYEBALL EXCEPT CONJUNCTIVA CORNEA RETINA AND CHOROID

190.1 MALIGNANT NEOPLASM OF ORBIT

190.2 MALIGNANT NEOPLASM OF LACRIMAL GLAND

190.3 MALIGNANT NEOPLASM OF CONJUNCTIVA

190.4 MALIGNANT NEOPLASM OF CORNEA

190.5 MALIGNANT NEOPLASM OF RETINA

190.6 MALIGNANT NEOPLASM OF CHOROID

190.7 MALIGNANT NEOPLASM OF LACRIMAL DUCT

190.8 MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF EYE

190.9 MALIGNANT NEOPLASM OF EYE PART UNSPECIFIED

191.0 MALIGNANT NEOPLASM OF CEREBRUM EXCEPT LOBES AND VENTRICLES

191.1 MALIGNANT NEOPLASM OF FRONTAL LOBE

191.2 MALIGNANT NEOPLASM OF TEMPORAL LOBE

191.3 MALIGNANT NEOPLASM OF PARIETAL LOBE

191.4 MALIGNANT NEOPLASM OF OCCIPITAL LOBE

191.5 MALIGNANT NEOPLASM OF VENTRICLES

191.6 MALIGNANT NEOPLASM OF CEREBELLUM NOS

191.7 MALIGNANT NEOPLASM OF BRAIN STEM

191.8 MALIGNANT NEOPLASM OF OTHER PARTS OF BRAIN

191.9 MALIGNANT NEOPLASM OF BRAIN UNSPECIFIED SITE

192.0 MALIGNANT NEOPLASM OF CRANIAL NERVES

192.1 MALIGNANT NEOPLASM OF CEREBRAL MENINGES

198.4 SECONDARY MALIGNANT NEOPLASM OF OTHER PARTS OF NERVOUS SYSTEM

224.0 BENIGN NEOPLASM OF EYEBALL EXCEPT CONJUNCTIVA CORNEA RETINA AND CHOROID

224.1 BENIGN NEOPLASM OF ORBIT

224.2 BENIGN NEOPLASM OF LACRIMAL GLAND

224.3 BENIGN NEOPLASM OF CONJUNCTIVA

224.4 BENIGN NEOPLASM OF CORNEA

224.5 BENIGN NEOPLASM OF RETINA

224.6 BENIGN NEOPLASM OF CHOROID

224.7 BENIGN NEOPLASM OF LACRIMAL DUCT

224.8 BENIGN NEOPLASM OF OTHER SPECIFIED PARTS OF EYE

224.9 BENIGN NEOPLASM OF EYE PART UNSPECIFIED

225.1 BENIGN NEOPLASM OF CRANIAL NERVES

227.3 BENIGN NEOPLASM OF PITUITARY GLAND AND CRANIOPHARYNGEAL DUCT

234.0 CARCINOMA IN SITU OF EYE

237.0 NEOPLASM OF UNCERTAIN BEHAVIOR OF PITUITARY GLAND AND CRANIOPHARYNGEAL DUCT

237.1 NEOPLASM OF UNCERTAIN BEHAVIOR OF PINEAL GLAND

237.70 NEUROFIBROMATOSIS UNSPECIFIED

237.73 SCHWANNOMATOSIS

237.79 OTHER NEUROFIBROMATOSIS

239.7 NEOPLASM OF UNSPECIFIED NATURE OF ENDOCRINE GLANDS AND OTHER PARTS OF NERVOUS SYSTEM

239.81 NEOPLASMS OF UNSPECIFIED NATURE, RETINA AND CHOROID

239.89 NEOPLASMS OF UNSPECIFIED NATURE, OTHER SPECIFIED SITES

242.00 TOXIC DIFFUSE GOITER WITHOUT THYROTOXIC CRISIS OR STORM

242.01 TOXIC DIFFUSE GOITER WITH THYROTOXIC CRISIS OR STORM

242.10 TOXIC UNINODULAR GOITER WITHOUT THYROTOXIC CRISIS OR STORM

242.11 TOXIC UNINODULAR GOITER WITH THYROTOXIC CRISIS OR STORM

250.50 DIABETES WITH OPHTHALMIC MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, NOT STATED AS UNCONTROLLED

250.51 DIABETES WITH OPHTHALMIC MANIFESTATIONS, TYPE I [JUVENILE TYPE], NOT STATED AS UNCONTROLLED

250.52 DIABETES WITH OPHTHALMIC MANIFESTATIONS, TYPE II OR UNSPECIFIED TYPE, UNCONTROLLED

250.53 DIABETES WITH OPHTHALMIC MANIFESTATIONS, TYPE I [JUVENILE TYPE], UNCONTROLLED

259.8 OTHER SPECIFIED ENDOCRINE DISORDERS

264.0 VITAMIN A DEFICIENCY WITH CONJUNCTIVAL XEROSIS

264.1 VITAMIN A DEFICIENCY WITH CONJUNCTIVAL XEROSIS AND BITOT'S SPOT

264.2 VITAMIN A DEFICIENCY WITH CORNEAL XEROSIS

264.3 VITAMIN A DEFICIENCY WITH CORNEAL ULCERATION AND XEROSIS

264.4 VITAMIN A DEFICIENCY WITH KERATOMALACIA

264.5 VITAMIN A DEFICIENCY WITH NIGHT BLINDNESS

264.6 VITAMIN A DEFICIENCY WITH XEROPHTHALMIC SCARS OF CORNEA

264.7 OTHER OCULAR MANIFESTATIONS OF VITAMIN A DEFICIENCY

264.8 OTHER MANIFESTATIONS OF VITAMIN A DEFICIENCY

264.9 UNSPECIFIED VITAMIN A DEFICIENCY

282.60 SICKLE-CELL DISEASE UNSPECIFIED

282.61 HB-SS DISEASE WITHOUT CRISIS

282.62 HB-SS DISEASE WITH CRISIS

282.63 SICKLE-CELL/HB-C DISEASE WITHOUT CRISIS

282.64 SICKLE-CELL/HB C DISEASE WITH CRISIS

282.68 OTHER SICKLE-CELL DISEASE WITHOUT CRISIS

282.69 OTHER SICKLE-CELL DISEASE WITH CRISIS

300.11 CONVERSION DISORDER

346.00 MIGRAINE WITH AURA, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.01 MIGRAINE WITH AURA, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.02 MIGRAINE WITH AURA, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.03 MIGRAINE WITH AURA, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.10 MIGRAINE WITHOUT AURA, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.11 MIGRAINE WITHOUT AURA, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.12 MIGRAINE WITHOUT AURA, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.13 MIGRAINE WITHOUT AURA, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.20 VARIANTS OF MIGRAINE, NOT ELSEWHERE CLASSIFIED, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.21 VARIANTS OF MIGRAINE, NOT ELSEWHERE CLASSIFIED, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.22 VARIANTS OF MIGRAINE, NOT ELSEWHERE CLASSIFIED, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.23 VARIANTS OF MIGRAINE, NOT ELSEWHERE CLASSIFIED, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.30 HEMIPLEGIC MIGRAINE, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.31 HEMIPLEGIC MIGRAINE, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.32 HEMIPLEGIC MIGRAINE, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.33 HEMIPLEGIC MIGRAINE, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.40 MENSTRUAL MIGRAINE, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.41 MENSTRUAL MIGRAINE, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.42 MENSTRUAL MIGRAINE, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.43 MENSTRUAL MIGRAINE, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.50 PERSISTENT MIGRAINE AURA WITHOUT CEREBRAL INFARCTION, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.51 PERSISTENT MIGRAINE AURA WITHOUT CEREBRAL INFARCTION, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.52 PERSISTENT MIGRAINE AURA WITHOUT CEREBRAL INFARCTION, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.53 PERSISTENT MIGRAINE AURA WITHOUT CEREBRAL INFARCTION, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.60 PERSISTENT MIGRAINE AURA WITH CEREBRAL INFARCTION, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.61 PERSISTENT MIGRAINE AURA WITH CEREBRAL INFARCTION, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.62 PERSISTENT MIGRAINE AURA WITH CEREBRAL INFARCTION, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.63 PERSISTENT MIGRAINE AURA WITH CEREBRAL INFARCTION, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.70 CHRONIC MIGRAINE WITHOUT AURA, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.71 CHRONIC MIGRAINE WITHOUT AURA, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.72 CHRONIC MIGRAINE WITHOUT AURA, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.73 CHRONIC MIGRAINE WITHOUT AURA, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.80 OTHER FORMS OF MIGRAINE, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.81 OTHER FORMS OF MIGRAINE, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.82 OTHER FORMS OF MIGRAINE, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.83 OTHER FORMS OF MIGRAINE, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

346.90 MIGRAINE, UNSPECIFIED, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITHOUT MENTION OF STATUS MIGRAINOSUS

346.91 MIGRAINE, UNSPECIFIED, WITH INTRACTABLE MIGRAINE, SO STATED, WITHOUT MENTION OF STATUS MIGRAINOSUS

346.92 MIGRAINE, UNSPECIFIED, WITHOUT MENTION OF INTRACTABLE MIGRAINE WITH STATUS MIGRAINOSUS

346.93 MIGRAINE, UNSPECIFIED, WITH INTRACTABLE MIGRAINE, SO STATED, WITH STATUS MIGRAINOSUS

348.2 BENIGN INTRACRANIAL HYPERTENSION

360.00 PURULENT ENDOPHTHALMITIS UNSPECIFIED

360.01 ACUTE ENDOPHTHALMITIS

360.02 PANOPHTHALMITIS

360.03 CHRONIC ENDOPHTHALMITIS

360.04 VITREOUS ABSCESS

360.11 SYMPATHETIC UVEITIS

360.12 PANUVEITIS

360.13 PARASITIC ENDOPHTHALMITIS UNSPECIFIED

360.14 OPHTHALMIA NODOSA

360.19 OTHER ENDOPHTHALMITIS

360.20 DEGENERATIVE DISORDER OF GLOBE UNSPECIFIED

360.21 PROGRESSIVE HIGH (DEGENERATIVE) MYOPIA

360.23 SIDEROSIS OF GLOBE

360.24 OTHER METALLOSIS OF GLOBE

360.29 OTHER DEGENERATIVE DISORDERS OF GLOBE

360.30 HYPOTONY OF EYE UNSPECIFIED

360.31 PRIMARY HYPOTONY OF EYE

360.32 OCULAR FISTULA CAUSING HYPOTONY

360.33 HYPOTONY ASSOCIATED WITH OTHER OCULAR DISORDERS

360.34 FLAT ANTERIOR CHAMBER OF EYE

360.40 DEGENERATED GLOBE OR EYE UNSPECIFIED

360.41 BLIND HYPOTENSIVE EYE

360.42 BLIND HYPERTENSIVE EYE

360.43 HEMOPHTHALMOS EXCEPT CURRENT INJURY

360.44 LEUCOCORIA

360.50 FOREIGN BODY MAGNETIC INTRAOCULAR UNSPECIFIED

360.51 FOREIGN BODY MAGNETIC IN ANTERIOR CHAMBER OF EYE

360.52 FOREIGN BODY MAGNETIC IN IRIS OR CILIARY BODY

360.53 FOREIGN BODY MAGNETIC IN LENS

360.54 FOREIGN BODY MAGNETIC IN VITREOUS

360.55 FOREIGN BODY MAGNETIC IN POSTERIOR WALL

360.59 INTRAOCULAR FOREIGN BODY MAGNETIC IN OTHER OR MULTIPLE SITES

360.60 FOREIGN BODY INTRAOCULAR UNSPECIFIED

360.61 FOREIGN BODY IN ANTERIOR CHAMBER

360.62 FOREIGN BODY IN IRIS OR CILIARY BODY

360.63 FOREIGN BODY IN LENS

360.64 FOREIGN BODY IN VITREOUS

360.65 FOREIGN BODY IN POSTERIOR WALL OF EYE

360.69 INTRAOCULAR FOREIGN BODY IN OTHER OR MULTIPLE SITES

360.81 LUXATION OF GLOBE

360.89 OTHER DISORDERS OF GLOBE

360.9 UNSPECIFIED DISORDER OF GLOBE

361.00 RETINAL DETACH WITH RETINAL DEFECT UNSPECIFIED

361.01 RECENT RETINAL DETACH PARTIAL WITH SINGLE DEFECT

361.02 RECENT RETINAL DETACH PARTIAL WITH MULTIPLE DEFECTS

361.03 RECENT RETINAL DETACH PARTIAL WITH GIANT TEAR

361.04 RECENT RETINAL DETACH PARTIAL WITH RETINAL DIALYSIS

361.05 RECENT RETINAL DETACH TOTAL OR SUBTOTAL

361.06 OLD RETINAL DETACH PARTIAL

361.07 OLD RETINAL DETACH TOTAL OR SUBTOTAL

361.10 RETINOSCHISIS UNSPECIFIED

361.11 FLAT RETINOSCHISIS

361.12 BULLOUS RETINOSCHISIS

361.13 PRIMARY RETINAL CYSTS

361.14 SECONDARY RETINAL CYSTS

361.19 OTHER RETINOSCHISIS AND RETINAL CYSTS

361.2 SEROUS RETINAL DETACH

361.30 RETINAL DEFECT UNSPECIFIED

361.31 ROUND HOLE OF RETINA WITHOUT DETACH

361.32 HORSESHOE TEAR OF RETINA WITHOUT DETACH

361.33 MULTIPLE DEFECTS OF RETINA WITHOUT DETACH

361.81 TRACTION DETACH OF RETINA

361.89 OTHER FORMS OF RETINAL DETACH

361.9 UNSPECIFIED RETINAL DETACH

362.01 BACKGROUND DIABETIC RETINOPATHY

362.02 PROLIFERATIVE DIABETIC RETINOPATHY

362.03 NONPROLIFERATIVE DIABETIC RETINOPATHY NOS

362.04 MILD NONPROLIFERATIVE DIABETIC RETINOPATHY

362.05 MODERATE NONPROLIFERATIVE DIABETIC RETINOPATHY

362.06 SEVERE NONPROLIFERATIVE DIABETIC RETINOPATHY

362.07* DIABETIC MACULAR EDEMA

362.10 BACKGROUND RETINOPATHY UNSPECIFIED

362.11 HYPERTENSIVE RETINOPATHY

362.12 EXUDATIVE RETINOPATHY

362.13 CHANGES IN VASCULAR APPEARANCE OF RETINA

362.14 RETINAL MICROANEURYSMS NOS

362.15 RETINAL TELANGIECTASIA

362.16 RETINAL NEOVASCULARIZATION NOS

362.17 OTHER INTRARETINAL MICROVASCULAR ABNORMALITIES

362.18 RETINAL VASCULITIS

362.21 RETROLENTAL FIBROPLASIA

362.29 OTHER NONDIABETIC PROLIFERATIVE RETINOPATHY

362.30 RETINAL VASCULAR OCCLUSION UNSPECIFIED

362.31 CENTRAL RETINAL ARTERY OCCLUSION

362.32 RETINAL ARTERIAL BRANCH OCCLUSION

362.33 PARTIAL RETINAL ARTERIAL OCCLUSION

362.34 TRANSIENT RETINAL ARTERIAL OCCLUSION

362.35 CENTRAL RETINAL VEIN OCCLUSION

362.36 VENOUS TRIBUTARY (BRANCH) OCCLUSION OF RETINA

362.37 VENOUS ENGORGEMENT OF RETINA

362.40 RETINAL LAYER SEPARATION UNSPECIFIED

362.41 CENTRAL SEROUS RETINOPATHY

362.42 SEROUS DETACH OF RETINAL PIGMENT EPITHELIUM

362.43 HEMORRHAGIC DETACH OF RETINAL PIGMENT EPITHELIUM

362.50 MACULAR DEGENERATION (SENILE) OF RETINA UNSPECIFIED

362.51 NONEXUDATIVE SENILE MACULAR DEGENERATION OF RETINA

362.52 EXUDATIVE SENILE MACULAR DEGENERATION OF RETINA

362.53 CYSTOID MACULAR DEGENERATION OF RETINA

362.54 MACULAR CYST HOLE OR PSEUDOHOLE OF RETINA

362.55 TOXIC MACULOPATHY OF RETINA

362.56 MACULAR PUCKERING OF RETINA

362.57 DRUSEN (DEGENERATIVE) OF RETINA

362.60 PERIPHERAL RETINAL DEGENERATION UNSPECIFIED

362.61 PAVING STONE DEGENERATION OF RETINA

362.62 MICROCYSTOID DEGENERATION OF RETINA

362.63 LATTICE DEGENERATION OF RETINA

362.64 SENILE RETICULAR DEGENERATION OF RETINA

362.65 SECONDARY PIGMENTARY DEGENERATION OF RETINA

362.66 SECONDARY VITREORETINAL DEGENERATIONS

362.70 HEREDITARY RETINAL DYSTROPHY UNSPECIFIED

362.71 RETINAL DYSTROPHY IN SYSTEMIC OR CEREBRORETINAL LIPIDOSES

362.72 RETINAL DYSTROPHY IN OTHER SYSTEMIC DISORDERS AND SYNDROMES

362.73 VITREORETINAL DYSTROPHIES

362.74 PIGMENTARY RETINAL DYSTROPHY

362.75 OTHER DYSTROPHIES PRIMARILY INVOLVING THE SENSORY RETINA

362.76 DYSTROPHIES PRIMARILY INVOLVING THE RETINAL PIGMENT EPITHELIUM

362.77 RETINAL DYSTROPHIES PRIMARILY INVOLVING BRUCH'S MEMBRANE

362.81 RETINAL HEMORRHAGE

362.82 RETINAL EXUDATES AND DEPOSITS

362.83 RETINAL EDEMA

362.84 RETINAL ISCHEMIA

362.85 RETINAL NERVE FIBER BUNDLE DEFECTS

362.89 OTHER RETINAL DISORDERS

362.9 UNSPECIFIED RETINAL DISORDER

363.00 FOCAL CHORIORETINITIS UNSPECIFIED

363.01 FOCAL CHOROIDITIS AND CHORIORETINITIS JUXTAPAPILLARY

363.03 FOCAL CHOROIDITIS AND CHORIORETINITIS OF OTHER POSTERIOR POLE

363.04 FOCAL CHOROIDITIS AND CHORIORETINITIS PERIPHERAL

363.05 FOCAL RETINITIS AND RETINOCHOROIDITIS JUXTAPAPILLARY

363.06 FOCAL RETINITIS AND RETINOCHOROIDITIS MACULAR OR PARAMACULAR

363.07 FOCAL RETINITIS AND RETINOCHOROIDITIS OF OTHER POSTERIOR POLE

363.08 FOCAL RETINITIS AND RETINOCHOROIDITIS PERIPHERAL

363.10 DISSEMINATED CHORIORETINITIS UNSPECIFIED

363.11 DISSEMINATED CHOROIDITIS AND CHORIORETINITIS POSTERIOR POLE

363.12 DISSEMINATED CHOROIDITIS AND CHORIORETINITIS PERIPHERAL

363.13 DISSEMINATED CHOROIDITIS AND CHORIORETINITIS GENERALIZED

363.14 DISSEMINATED RETINITIS AND RETINOCHOROIDITIS METASTATIC

363.15 DISSEMINATED RETINITIS AND RETINOCHOROIDITIS PIGMENT EPITHELIOPATHY

363.20 CHORIORETINITIS UNSPECIFIED

363.21 PARS PLANITIS

363.22 HARADA'S DISEASE

363.30 CHORIORETINAL SCAR UNSPECIFIED

363.31 SOLAR RETINOPATHY

363.32 OTHER MACULAR SCARS OF RETINA

363.33 OTHER SCARS OF POSTERIOR POLE OF RETINA

363.34 PERIPHERAL SCARS OF RETINA

363.35 DISSEMINATED SCARS OF RETINA

363.40 CHOROIDAL DEGENERATION UNSPECIFIED

363.41 SENILE ATROPHY OF CHOROID

363.42 DIFFUSE SECONDARY ATROPHY OF CHOROID

363.43 ANGIOID STREAKS OF CHOROID

363.50 HEREDITARY CHOROIDAL DYSTROPHY OR ATROPHY UNSPECIFIED

363.51 CIRCUMPAPILLARY DYSTROPHY OF CHOROID PARTIAL

363.52 CIRCUMPAPILLARY DYSTROPHY OF CHOROID TOTAL

363.53 CENTRAL DYSTROPHY OF CHOROID PARTIAL

363.54 CENTRAL CHOROIDAL ATROPHY TOTAL

363.55 CHOROIDEREMIA

363.56 OTHER DIFFUSE OR GENERALIZED DYSTROPHY OF CHOROID PARTIAL

363.57 OTHER DIFFUSE OR GENERALIZED DYSTROPHY OF CHOROID TOTAL

363.61 CHOROIDAL HEMORRHAGE UNSPECIFIED

363.62 EXPULSIVE CHOROIDAL HEMORRHAGE

363.63 CHOROIDAL RUPTURE

363.70 CHOROIDAL DETACH UNSPECIFIED

363.71 SEROUS CHOROIDAL DETACH

363.72 HEMORRHAGIC CHOROIDAL DETACH

363.8 OTHER DISORDERS OF CHOROID

363.9 UNSPECIFIED DISORDER OF CHOROID

364.00 ACUTE AND SUBACUTE IRIDOCYCLITIS UNSPECIFIED

364.01 PRIMARY IRIDOCYCLITIS

364.02 RECURRENT IRIDOCYCLITIS

364.03 SECONDARY IRIDOCYCLITIS INFECTIOUS

364.04 SECONDARY IRIDOCYCLITIS NONINFECTIOUS

364.05 HYPOPYON

364.10 CHRONIC IRIDOCYCLITIS UNSPECIFIED

364.11 CHRONIC IRIDOCYCLITIS IN DISEASES CLASSIFIED ELSEWHERE

364.21 FUCHS' HETEROCHROMIC CYCLITIS

364.22 GLAUCOMATOCYCLITIC CRISES

364.23 LENS-INDUCED IRIDOCYCLITIS

364.24 VOGT-KOYANAGI SYNDROME

364.3 UNSPECIFIED IRIDOCYCLITIS

364.41 HYPHEMA OF IRIS AND CILIARY BODY

364.42 RUBEOSIS IRIDIS

364.51 ESSENTIAL OR PROGRESSIVE IRIS ATROPHY

364.52 IRIDOSCHISIS

364.53 PIGMENTARY IRIS DEGENERATION

364.54 DEGENERATION OF PUPILLARY MARGIN

364.55 MIOTIC CYSTS OF PUPILLARY MARGIN

364.56 DEGENERATIVE CHANGES OF CHAMBER ANGLE

364.57 DEGENERATIVE CHANGES OF CILIARY BODY

364.59 OTHER IRIS ATROPHY

364.60 IDIOPATHIC CYSTS OF IRIS AND CILIARY BODY

364.61 IMPLANTATION CYSTS OF IRIS AND CILIARY BODY

364.62 EXUDATIVE CYSTS OF IRIS OR ANTERIOR CHAMBER

364.63 PRIMARY CYST OF PARS PLANA

364.64 EXUDATIVE CYST OF PARS PLANA

364.70 ADHESIONS OF IRIS UNSPECIFIED

364.71 POSTERIOR SYNECHIAE OF IRIS

364.72 ANTERIOR SYNECHIAE OF IRIS

364.73 GONIOSYNECHIAE

364.74 ADHESIONS AND DISRUPTIONS OF PUPILLARY MEMBRANES

364.75 PUPILLARY ABNORMALITIES

364.76 IRIDODIALYSIS

364.77 RECESSION OF CHAMBER ANGLE OF EYE

364.81 FLOPPY IRIS SYNDROME

364.82 PLATEAU IRIS SYNDROME

364.89 OTHER DISORDERS OF IRIS AND CILIARY BODY

364.9 UNSPECIFIED DISORDER OF IRIS AND CILIARY BODY

365.00 PREGLAUCOMA UNSPECIFIED

365.01 OPEN ANGLE WITH BORDERLINE FINDINGS, LOW RISK

365.02 ANATOMICAL NARROW ANGLE BORDERLINE GLAUCOMA

365.03 STEROID RESPONDERS BORDERLINE GLAUCOMA

365.04 OCULAR HYPERTENSION

365.05 OPEN ANGLE WITH BORDERLINE FINDINGS, HIGH RISK

365.06 PRIMARY ANGLE CLOSURE WITHOUT GLAUCOMA DAMAGE

365.10 OPEN-ANGLE GLAUCOMA UNSPECIFIED

365.11 PRIMARY OPEN ANGLE GLAUCOMA

365.12 LOW TENSION OPEN-ANGLE GLAUCOMA

365.13 PIGMENTARY OPEN-ANGLE GLAUCOMA

365.14 GLAUCOMA OF CHILDHOOD

365.15 RESIDUAL STAGE OF OPEN ANGLE GLAUCOMA

365.20 PRIMARY ANGLE-CLOSURE GLAUCOMA UNSPECIFIED

365.21 INTERMITTENT ANGLE-CLOSURE GLAUCOMA

365.22 ACUTE ANGLE-CLOSURE GLAUCOMA

365.23 CHRONIC ANGLE-CLOSURE GLAUCOMA

365.24 RESIDUAL STAGE OF ANGLE-CLOSURE GLAUCOMA

365.31 CORTICOSTEROID-INDUCED GLAUCOMA GLAUCOMATOUS STAGE

365.32 CORTICOSTEROID-INDUCED GLAUCOMA RESIDUAL STAGE

365.41 GLAUCOMA ASSOCIATED WITH CHAMBER ANGLE ANOMALIES

365.42 GLAUCOMA ASSOCIATED WITH ANOMALIES OF IRIS

365.43 GLAUCOMA ASSOCIATED WITH OTHER ANTERIOR SEGMENT ANOMALIES

365.44 GLAUCOMA ASSOCIATED WITH SYSTEMIC SYNDROMES

365.51 PHACOLYTIC GLAUCOMA

365.52 PSEUDOEXFOLIATION GLAUCOMA

365.59 GLAUCOMA ASSOCIATED WITH OTHER LENS DISORDERS

365.60 GLAUCOMA ASSOCIATED WITH UNSPECIFIED OCULAR DISORDER

365.61 GLAUCOMA ASSOCIATED WITH PUPILLARY BLOCK

365.62 GLAUCOMA ASSOCIATED WITH OCULAR INFLAMMATIONS

365.63 GLAUCOMA ASSOCIATED WITH VASCULAR DISORDERS OF EYE

365.64 GLAUCOMA ASSOCIATED WITH TUMORS OR CYSTS

365.65 GLAUCOMA ASSOCIATED WITH OCULAR TRAUMA

365.81 HYPERSECRETION GLAUCOMA

365.82 GLAUCOMA WITH INCREASED EPISCLERAL VENOUS PRESSURE

365.83 AQUEOUS MISDIRECTION

365.89 OTHER SPECIFIED GLAUCOMA

365.9 UNSPECIFIED GLAUCOMA

366.00 NONSENILE CATARACT UNSPECIFIED

366.01 ANTERIOR SUBCAPSULAR POLAR NONSENILE CATARACT

366.02 POSTERIOR SUBCAPSULAR POLAR NONSENILE CATARACT

366.03 CORTICAL LAMELLAR OR ZONULAR NONSENILE CATARACT

366.04 NUCLEAR NONSENILE CATARACT

366.09 OTHER AND COMBINED FORMS OF NONSENILE CATARACT

366.10 SENILE CATARACT UNSPECIFIED

366.11 PSEUDOEXFOLIATION OF LENS CAPSULE

366.12 INCIPIENT SENILE CATARACT

366.13 ANTERIOR SUBCAPSULAR POLAR SENILE CATARACT

366.14 POSTERIOR SUBCAPSULAR POLAR SENILE CATARACT

366.15 CORTICAL SENILE CATARACT

366.16 SENILE NUCLEAR SCLEROSIS

366.17 TOTAL OR MATURE CATARACT

366.18 HYPERMATURE CATARACT

366.19 OTHER AND COMBINED FORMS OF SENILE CATARACT

366.20 TRAUMATIC CATARACT UNSPECIFIED

366.21 LOCALIZED TRAUMATIC OPACITIES

366.22 TOTAL TRAUMATIC CATARACT

366.23 PARTIALLY RESOLVED TRAUMATIC CATARACT

366.30 CATARACTA COMPLICATA UNSPECIFIED

366.31 CATARACT SECONDARY TO GLAUCOMATOUS FLECKS (SUBCAPSULAR)

366.32 CATARACT IN INFLAMMATORY OCULAR DISORDERS

366.33 CATARACT WITH OCULAR NEOVASCULARIZATION

366.34 CATARACT IN DEGENERATIVE OCULAR DISORDERS

366.41 DIABETIC CATARACT

366.42 TETANIC CATARACT

366.43 MYOTONIC CATARACT

366.44 CATARACT ASSOCIATED WITH OTHER SYNDROMES

366.45 TOXIC CATARACT

366.46 CATARACT ASSOCIATED WITH RADIATION AND OTHER PHYSICAL INFLUENCES

366.50 AFTER-CATARACT UNSPECIFIED

366.51 SOEMMERING'S RING

366.52 OTHER AFTER-CATARACT NOT OBSCURING VISION

366.53 AFTER-CATARACT OBSCURING VISION

366.8 OTHER CATARACT

366.9 UNSPECIFIED CATARACT

368.00 AMBLYOPIA UNSPECIFIED

368.01 STRABISMIC AMBLYOPIA

368.02 DEPRIVATION AMBLYOPIA

368.03 REFRACTIVE AMBLYOPIA

368.10 SUBJECTIVE VISUAL DISTURBANCE UNSPECIFIED

368.11 SUDDEN VISUAL LOSS

368.12 TRANSIENT VISUAL LOSS

368.13 VISUAL DISCOMFORT

368.14 VISUAL DISTORTIONS OF SHAPE AND SIZE

368.15 OTHER VISUAL DISTORTIONS AND ENTOPTIC PHENOMENA

368.16 PSYCHOPHYSICAL VISUAL DISTURBANCES

368.2 DIPLOPIA

368.30 BINOCULAR VISION DISORDER UNSPECIFIED

368.31 SUPPRESSION OF BINOCULAR VISION

368.32 SIMULTANEOUS VISUAL PERCEPTION WITHOUT FUSION

368.33 FUSION WITH DEFECTIVE STEREOPSIS

368.34 ABNORMAL RETINAL CORRESPONDENCE

368.40 VISUAL FIELD DEFECT UNSPECIFIED

368.41 SCOTOMA INVOLVING CENTRAL AREA

368.42 SCOTOMA OF BLIND SPOT AREA

368.43 SECTOR OR ARCUATE VISUAL FIELD DEFECTS

368.44 OTHER LOCALIZED VISUAL FIELD DEFECT

368.45 GENERALIZED VISUAL FIELD CONTRACTION OR CONSTRICTION

368.46 HOMONYMOUS BILATERAL FIELD DEFECTS

368.47 HETERONYMOUS BILATERAL FIELD DEFECTS

368.51 PROTAN DEFECT

368.52 DEUTAN DEFECT

368.53 TRITAN DEFECT

368.54 ACHROMATOPSIA

368.55 ACQUIRED COLOR VISION DEFICIENCIES

368.59 OTHER COLOR VISION DEFICIENCIES

368.60 NIGHT BLINDNESS UNSPECIFIED

368.61 CONGENITAL NIGHT BLINDNESS

368.62 ACQUIRED NIGHT BLINDNESS

368.63 ABNORMAL DARK ADAPTATION CURVE

368.69 OTHER NIGHT BLINDNESS

368.8 OTHER SPECIFIED VISUAL DISTURBANCES

368.9 UNSPECIFIED VISUAL DISTURBANCE

369.00 BLINDNESS OF BOTH EYES IMPAIRMENT LEVEL NOT FURTHER SPECIFIED

369.01 BETTER EYE: TOTAL VISION IMPAIRMENT; LESSER EYE: TOTAL VISION IMPAIRMENT

369.02 BETTER EYE: NEAR-TOTAL VISION IMPAIRMENT; LESSER EYE: NOT FURTHER SPECIFIED

369.03 BETTER EYE: NEAR-TOTAL VISION IMPAIRMENT; LESSER EYE: TOTAL VISION IMPAIRMENT

369.04 BETTER EYE: NEAR-TOTAL VISION IMPAIRMENT; LESSER EYE: NEAR-TOTAL VISION IMPAIRMENT

369.05 BETTER EYE: PROFOUND VISION IMPAIRMENT; LESSER EYE: NOT FURTHER SPECIFIED

369.06 BETTER EYE: PROFOUND VISION IMPAIRMENT; LESSER EYE: TOTAL VISION IMPAIRMENT

369.07 BETTER EYE: PROFOUND VISION IMPAIRMENT; LESSER EYE: NEAR-TOTAL VISION IMPAIRMENT

369.08 BETTER EYE: PROFOUND VISION IMPAIRMENT; LESSER EYE: PROFOUND VISION IMPAIRMENT

369.10 BLINDNESS ONE EYE; LOW VISION OTHER EYE

369.11 BETTER EYE: SEVERE VISION IMPAIRMENT; LESSER EYE: BLIND NOT FURTHER SPECIFIED

369.12 BETTER EYE: SEVERE VISION IMPAIRMENT; LESSER EYE: TOTAL VISION IMPAIRMENT

369.13 BETTER EYE: SEVERE VISION IMPAIRMENT; LESSER EYE: NEAR-TOTAL VISION IMPAIRMENT

369.14 BETTER EYE: SEVERE VISION IMPAIRMENT; LESSER EYE: PROFOUND VISION IMPAIRMENT

369.15 BETTER EYE: MODERATE VISION IMPAIRMENT; LESSER EYE: BLIND NOT FURTHER SPECIFIED

369.16 BETTER EYE: MODERATE VISION IMPAIRMENT; LESSER EYE: TOTAL VISION IMPAIRMENT

369.17 BETTER EYE: MODERATE VISION IMPAIRMENT; LESSER EYE: NEAR-TOTAL VISION IMPAIRMENT

369.18 BETTER EYE: MODERATE VISION IMPAIRMENT; LESSER EYE: PROFOUND VISION IMPAIRMENT

369.20 LOW VISION BOTH EYES NOT OTHERWISE SPECIFIED

369.21 BETTER EYE: SEVERE VISION IMPAIRMENT; LESSER EYE; IMPAIRMENT NOT FURTHER SPECIFIED

369.22 BETTER EYE: SEVERE VISION IMPAIRMENT; LESSER EYE: SEVERE VISION IMPAIRMENT

369.23 BETTER EYE: MODERATE VISION IMPAIRMENT; LESSER EYE: IMPAIRMENT NOT FURTHER SPECIFIED

369.24 BETTER EYE: MODERATE VISION IMPAIRMENT; LESSER EYE: SEVERE VISION IMPAIRMENT

369.25 BETTER EYE: MODERATE VISION IMPAIRMENT; LESSER EYE: MODERATE VISION IMPAIRMENT

369.3 UNQUALIFIED VISUAL LOSS BOTH EYES

369.4 LEGAL BLINDNESS AS DEFINED IN U.S.A.

369.60 BLINDNESS ONE EYE NOT OTHERWISE SPECIFIED

369.61 ONE EYE: TOTAL VISION IMPAIRMENT; OTHER EYE: NOT SPECIFIED

369.62 ONE EYE: TOTAL VISION IMPAIRMENT; OTHER EYE: NEAR-NORMAL VISION

369.63 ONE EYE: TOTAL VISION IMPAIRMENT; OTHER EYE: NORMAL VISION

369.64 ONE EYE: NEAR-TOTAL VISION IMPAIRMENT; OTHER EYE: VISION NOT SPECIFIED

369.65 ONE EYE: NEAR-TOTAL VISION IMPAIRMENT; OTHER EYE: NEAR-NORMAL VISION

369.66 ONE EYE: NEAR-TOTAL VISION IMPAIRMENT; OTHER EYE: NORMAL VISION

369.67 ONE EYE: PROFOUND VISION IMPAIRMENT; OTHER EYE: VISION NOT SPECIFIED

369.68 ONE EYE: PROFOUND VISION IMPAIRMENT; OTHER EYE: NEAR-NORMAL VISION

369.69 ONE EYE: PROFOUND VISION IMPAIRMENT; OTHER EYE: NORMAL VISION

369.70 LOW VISION ONE EYE NOT OTHERWISE SPECIFIED

369.71 ONE EYE: SEVERE VISION IMPAIRMENT; OTHER EYE: VISION NOT SPECIFIED

369.72 ONE EYE: SEVERE VISION IMPAIRMENT; OTHER EYE: NEAR-NORMAL VISION

369.73 ONE EYE: SEVERE VISION IMPAIRMENT; OTHER EYE: NORMAL VISION

369.74 ONE EYE: MODERATE VISION IMPAIRMENT; OTHER EYE: VISION NOT SPECIFIED

369.75 ONE EYE: MODERATE VISION IMPAIRMENT; OTHER EYE: NEAR-NORMAL VISION

369.76 ONE EYE: MODERATE VISION IMPAIRMENT; OTHER EYE: NORMAL VISION

369.8 UNQUALIFIED VISUAL LOSS ONE EYE

369.9 UNSPECIFIED VISUAL LOSS

370.00 CORNEAL ULCER UNSPECIFIED

370.01 MARGINAL CORNEAL ULCER

370.02 RING CORNEAL ULCER

370.03 CENTRAL CORNEAL ULCER

370.04 HYPOPYON ULCER

370.05 MYCOTIC CORNEAL ULCER

370.06 PERFORATED CORNEAL ULCER

370.07 MOOREN'S ULCER

370.20 SUPERFICIAL KERATITIS UNSPECIFIED

370.21 PUNCTATE KERATITIS

370.22 MACULAR KERATITIS

370.23 FILAMENTARY KERATITIS

370.24 PHOTOKERATITIS

370.31 PHLYCTENULAR KERATOCONJUNCTIVITIS

370.32 LIMBAR AND CORNEAL INVOLVEMENT IN VERNAL CONJUNCTIVITIS

370.33 KERATOCONJUNCTIVITIS SICCA NOT SPECIFIED AS SJOGREN'S

370.34 EXPOSURE KERATOCONJUNCTIVITIS

370.35 NEUROTROPHIC KERATOCONJUNCTIVITIS

370.40 KERATOCONJUNCTIVITIS UNSPECIFIED

370.44 KERATITIS OR KERATOCONJUNCTIVITIS IN EXANTHEMA

370.49 OTHER KERATOCONJUNCTIVITIS UNSPECIFIED

370.50 INTERSTITIAL KERATITIS UNSPECIFIED

370.52 DIFFUSE INTERSTITIAL KERATITIS

370.54 SCLEROSING KERATITIS

370.55 CORNEAL ABSCESS

370.59 OTHER INTERSTITIAL AND DEEP KERATITIS

370.60 CORNEAL NEOVASCULARIZATION UNSPECIFIED

370.61 LOCALIZED VASCULARIZATION OF CORNEA

370.62 PANNUS (CORNEAL)

370.63 DEEP VASCULARIZATION OF CORNEA

370.64 GHOST VESSELS (CORNEAL)

370.8 OTHER FORMS OF KERATITIS

370.9 UNSPECIFIED KERATITIS

371.00 CORNEAL OPACITY UNSPECIFIED

371.01 MINOR OPACITY OF CORNEA

371.02 PERIPHERAL OPACITY OF CORNEA

371.03 CENTRAL OPACITY OF CORNEA

371.04 ADHERENT LEUCOMA

371.05 PHTHISICAL CORNEA

371.10 CORNEAL DEPOSIT UNSPECIFIED

371.11 ANTERIOR CORNEAL PIGMENTATIONS

371.12 STROMAL CORNEAL PIGMENTATIONS

371.13 POSTERIOR CORNEAL PIGMENTATIONS

371.14 KAYSER-FLEISCHER RING

371.15 OTHER CORNEAL DEPOSITS ASSOCIATED WITH METABOLIC DISORDERS

371.16 ARGENTOUS CORNEAL DEPOSITS

371.20 CORNEAL EDEMA UNSPECIFIED

371.21 IDIOPATHIC CORNEAL EDEMA

371.22 SECONDARY CORNEAL EDEMA

371.23 BULLOUS KERATOPATHY

371.24 CORNEAL EDEMA DUE TO WEARING OF CONTACT LENSES

371.30 CORNEAL MEMBRANE CHANGE UNSPECIFIED

371.31 FOLDS AND RUPTURE OF BOWMAN'S MEMBRANE

371.32 FOLDS IN DESCEMET'S MEMBRANE

371.33 RUPTURE IN DESCEMET'S MEMBRANE

371.40 CORNEAL DEGENERATION UNSPECIFIED

371.41 SENILE CORNEAL CHANGES

371.42 RECURRENT EROSION OF CORNEA

371.43 BAND-SHAPED KERATOPATHY

371.44 OTHER CALCEROUS DEGENERATIONS OF CORNEA

371.45 KERATOMALACIA NOS

371.46 NODULAR DEGENERATION OF CORNEA

371.48 PERIPHERAL DEGENERATIONS OF CORNEA

371.49 OTHER CORNEAL DEGENERATIONS

371.50 HEREDITARY CORNEAL DYSTROPHY UNSPECIFIED

371.51 JUVENILE EPITHELIAL CORNEAL DYSTROPHY

371.52 OTHER ANTERIOR CORNEAL DYSTROPHIES

371.53 GRANULAR CORNEAL DYSTROPHY

371.54 LATTICE CORNEAL DYSTROPHY

371.55 MACULAR CORNEAL DYSTROPHY

371.56 OTHER STROMAL CORNEAL DYSTROPHIES

371.57 ENDOTHELIAL CORNEAL DYSTROPHY

371.58 OTHER POSTERIOR CORNEAL DYSTROPHIES

371.60 KERATOCONUS UNSPECIFIED

371.61 KERATOCONUS STABLE CONDITION

371.62 KERATOCONUS ACUTE HYDROPS

371.70 CORNEAL DEFORMITY UNSPECIFIED

371.71 CORNEAL ECTASIA

371.72 DESCEMETOCELE

371.73 CORNEAL STAPHYLOMA

371.81 CORNEAL ANESTHESIA AND HYPOESTHESIA

371.82 CORNEAL DISORDER DUE TO CONTACT LENS

371.89 OTHER CORNEAL DISORDERS

371.9 UNSPECIFIED CORNEAL DISORDER

373.00 BLEPHARITIS UNSPECIFIED

373.01 ULCERATIVE BLEPHARITIS

373.02 SQUAMOUS BLEPHARITIS

373.11 HORDEOLUM EXTERNUM

373.12 HORDEOLUM INTERNUM

373.13 ABSCESS OF EYELID

373.2 CHALAZION

373.31 ECZEMATOUS DERMATITIS OF EYELID

373.32 CONTACT AND ALLERGIC DERMATITIS OF EYELID

373.33 XERODERMA OF EYELID

373.34 DISCOID LUPUS ERYTHEMATOSUS OF EYELID

373.8 OTHER INFLAMMATIONS OF EYELIDS

373.9 UNSPECIFIED INFLAMMATION OF EYELID

374.00 ENTROPION UNSPECIFIED

374.01 SENILE ENTROPION

374.02 MECHANICAL ENTROPION

374.03 SPASTIC ENTROPION

374.04 CICATRICIAL ENTROPION

374.05 TRICHIASIS OF EYELID WITHOUT ENTROPION

374.10 ECTROPION UNSPECIFIED

374.11 SENILE ECTROPION

374.12 MECHANICAL ECTROPION

374.13 SPASTIC ECTROPION

374.14 CICATRICIAL ECTROPION

374.20 LAGOPHTHALMOS UNSPECIFIED

374.21 PARALYTIC LAGOPHTHALMOS

374.22 MECHANICAL LAGOPHTHALMOS

374.23 CICATRICIAL LAGOPHTHALMOS

374.30 PTOSIS OF EYELID UNSPECIFIED

374.31 PARALYTIC PTOSIS

374.32 MYOGENIC PTOSIS

374.33 MECHANICAL PTOSIS

374.34 BLEPHAROCHALASIS

374.41 LID RETRACTION OR LAG

374.43 ABNORMAL INNERVATION SYNDROME OF EYELID

374.44 SENSORY DISORDERS OF EYELID

374.45 OTHER SENSORIMOTOR DISORDERS OF EYELID

374.46 BLEPHAROPHIMOSIS

374.50 DEGENERATIVE DISORDER OF EYELID UNSPECIFIED

374.51 XANTHELASMA OF EYELID

374.52 HYPERPIGMENTATION OF EYELID

374.53 HYPOPIGMENTATION OF EYELID

374.54 HYPERTRICHOSIS OF EYELID

374.55 HYPOTRICHOSIS OF EYELID

374.56 OTHER DEGENERATIVE DISORDERS OF SKIN AFFECTING EYELID

374.81 HEMORRHAGE OF EYELID

374.82 EDEMA OF EYELID

374.83 ELEPHANTIASIS OF EYELID

374.84 CYSTS OF EYELIDS

374.85 VASCULAR ANOMALIES OF EYELID

374.86 RETAINED FOREIGN BODY OF EYELID

374.87 DERMATOCHALASIS

374.89 OTHER DISORDERS OF EYELID

374.9 UNSPECIFIED DISORDER OF EYELID

376.00 ACUTE INFLAMMATION OF ORBIT UNSPECIFIED

376.01 ORBITAL CELLULITIS

376.02 ORBITAL PERIOSTITIS

376.03 ORBITAL OSTEOMYELITIS

376.04 ORBITAL TENONITIS

376.10 CHRONIC INFLAMMATION OF ORBIT UNSPECIFIED

376.11 ORBITAL GRANULOMA

376.12 ORBITAL MYOSITIS

376.13 PARASITIC INFESTATION OF ORBIT

376.21 THYROTOXIC EXOPHTHALMOS

376.22 EXOPHTHALMIC OPHTHALMOPLEGIA

376.30 EXOPHTHALMOS UNSPECIFIED

376.31 CONSTANT EXOPHTHALMOS

376.32 ORBITAL HEMORRHAGE

376.33 ORBITAL EDEMA OR CONGESTION

376.34 INTERMITTENT EXOPHTHALMOS

376.35 PULSATING EXOPHTHALMOS

376.36 LATERAL DISPLACEMENT OF GLOBE

376.40 DEFORMITY OF ORBIT UNSPECIFIED

376.41 HYPERTELORISM OF ORBIT

376.42 EXOSTOSIS OF ORBIT

376.43 LOCAL DEFORMITIES OF ORBIT DUE TO BONE DISEASE

376.44 ORBITAL DEFORMITIES ASSOCIATED WITH CRANIOFACIAL DEFORMITIES

376.45 ATROPHY OF ORBIT

376.46 ENLARGEMENT OF ORBIT

376.47 DEFORMITY OF ORBIT DUE TO TRAUMA OR SURGERY

376.50 ENOPHTHALMOS UNSPECIFIED AS TO CAUSE

376.51 ENOPHTHALMOS DUE TO ATROPHY OF ORBITAL TISSUE

376.52 ENOPHTHALMOS DUE TO TRAUMA OR SURGERY

376.6 RETAINED (OLD) FOREIGN BODY FOLLOWING PENETRATING WOUND OF ORBIT

376.81 ORBITAL CYSTS

376.82 MYOPATHY OF EXTRAOCULAR MUSCLES

376.89 OTHER ORBITAL DISORDERS

376.9 UNSPECIFIED DISORDER OF ORBIT

377.00 PAPILLEDEMA UNSPECIFIED

377.01 PAPILLEDEMA ASSOCIATED WITH INCREASED INTRACRANIAL PRESSURE

377.02 PAPILLEDEMA ASSOCIATED WITH DECREASED OCULAR PRESSURE

377.03 PAPILLEDEMA ASSOCIATED WITH RETINAL DISORDER

377.04 FOSTER-KENNEDY SYNDROME

377.10 OPTIC ATROPHY UNSPECIFIED

377.11 PRIMARY OPTIC ATROPHY

377.12 POSTINFLAMMATORY OPTIC ATROPHY

377.13 OPTIC ATROPHY ASSOCIATED WITH RETINAL DYSTROPHIES

377.14 GLAUCOMATOUS ATROPHY (CUPPING) OF OPTIC DISC

377.15 PARTIAL OPTIC ATROPHY

377.16 HEREDITARY OPTIC ATROPHY

377.21 DRUSEN OF OPTIC DISC

377.22 CRATER-LIKE HOLES OF OPTIC DISC

377.23 COLOBOMA OF OPTIC DISC

377.24 PSEUDOPAPILLEDEMA

377.30 OPTIC NEURITIS UNSPECIFIED

377.31 OPTIC PAPILLITIS

377.32 RETROBULBAR NEURITIS (ACUTE)

377.33 NUTRITIONAL OPTIC NEUROPATHY

377.34 TOXIC OPTIC NEUROPATHY

377.39 OTHER OPTIC NEURITIS

377.41 ISCHEMIC OPTIC NEUROPATHY

377.42 HEMORRHAGE IN OPTIC NERVE SHEATHS

377.43 OPTIC NERVE HYPOPLASIA

377.49 OTHER DISORDERS OF OPTIC NERVE

377.51 DISORDERS OF OPTIC CHIASM ASSOCIATED WITH PITUITARY NEOPLASMS AND DISORDERS

377.52 DISORDERS OF OPTIC CHIASM ASSOCIATED WITH OTHER NEOPLASMS

377.53 DISORDERS OF OPTIC CHIASM ASSOCIATED WITH VASCULAR DISORDERS

377.54 DISORDERS OF OPTIC CHIASM ASSOCIATED WITH INFLAMMATORY DISORDERS

377.61 DISORDERS OF OTHER VISUAL PATHWAYS ASSOCIATED WITH NEOPLASMS

377.62 DISORDERS OF OTHER VISUAL PATHWAYS ASSOCIATED WITH VASCULAR DISORDERS

377.63 DISORDERS OF OTHER VISUAL PATHWAYS ASSOCIATED WITH INFLAMMATORY DISORDERS

377.71 DISORDERS OF VISUAL CORTEX ASSOCIATED WITH NEOPLASMS

377.72 DISORDERS OF VISUAL CORTEX ASSOCIATED WITH VASCULAR DISORDERS

377.73 DISORDERS OF VISUAL CORTEX ASSOCIATED WITH INFLAMMATORY DISORDERS

377.75 CORTICAL BLINDNESS

377.9 UNSPECIFIED DISORDER OF OPTIC NERVE AND VISUAL PATHWAYS

378.00 ESOTROPIA UNSPECIFIED

378.01 MONOCULAR ESOTROPIA

378.02 MONOCULAR ESOTROPIA WITH A PATTERN

378.03 MONOCULAR ESOTROPIA WITH V PATTERN

378.04 MONOCULAR ESOTROPIA WITH OTHER NONCOMITANCIES

378.05 ALTERNATING ESOTROPIA

378.06 ALTERNATING ESOTROPIA WITH A PATTERN

378.07 ALTERNATING ESOTROPIA WITH V PATTERN

378.08 ALTERNATING ESOTROPIA WITH OTHER NONCOMITANCIES

378.10 EXOTROPIA UNSPECIFIED

378.11 MONOCULAR EXOTROPIA

378.12 MONOCULAR EXOTROPIA WITH A PATTERN

378.13 MONOCULAR EXOTROPIA WITH V PATTERN

378.14 MONOCULAR EXOTROPIA WITH OTHER NONCOMITANCIES

378.15 ALTERNATING EXOTROPIA

378.16 ALTERNATING EXOTROPIA WITH A PATTERN

378.17 ALTERNATING EXOTROPIA WITH V PATTERN

378.18 ALTERNATING EXOTROPIA WITH OTHER NONCOMITANCIES

378.20 INTERMITTENT HETEROTROPIA UNSPECIFIED

378.21 INTERMITTENT ESOTROPIA MONOCULAR

378.22 INTERMITTENT ESOTROPIA ALTERNATING

378.23 INTERMITTENT EXOTROPIA MONOCULAR

378.24 INTERMITTENT EXOTROPIA ALTERNATING

378.30 HETEROTROPIA UNSPECIFIED

378.31 HYPERTROPIA

378.32 HYPOTROPIA

378.33 CYCLOTROPIA

378.34 MONOFIXATION SYNDROME

378.35 ACCOMMODATIVE COMPONENT IN ESOTROPIA

378.40 HETEROPHORIA UNSPECIFIED

378.41 ESOPHORIA

378.42 EXOPHORIA

378.43 VERTICAL HETEROPHORIA

378.44 CYCLOPHORIA

378.45 ALTERNATING HYPERPHORIA

378.50 PARALYTIC STRABISMUS UNSPECIFIED

378.51 THIRD OR OCULOMOTOR NERVE PALSY PARTIAL

378.52 THIRD OR OCULOMOTOR NERVE PALSY TOTAL

378.53 FOURTH OR TROCHLEAR NERVE PALSY

378.54 SIXTH OR ABDUCENS NERVE PALSY

378.55 EXTERNAL OPHTHALMOPLEGIA

378.56 TOTAL OPHTHALMOPLEGIA

378.60 MECHANICAL STRABISMUS UNSPECIFIED

378.61 BROWN'S (TENDON) SHEATH SYNDROME

378.62 MECHANICAL STRABISMUS FROM OTHER MUSCULOFASCIAL DISORDERS

378.63 LIMITED DUCTION ASSOCIATED WITH OTHER CONDITIONS

378.71 DUANE'S SYNDROME

378.72 PROGRESSIVE EXTERNAL OPHTHALMOPLEGIA

378.73 STRABISMUS IN OTHER NEUROMUSCULAR DISORDERS

378.81 PALSY OF CONJUGATE GAZE

378.82 SPASM OF CONJUGATE GAZE

378.83 CONVERGENCE INSUFFICIENCY OR PALSY

378.84 CONVERGENCE EXCESS OR SPASM

378.85 ANOMALIES OF DIVERGENCE

378.86 INTERNUCLEAR OPHTHALMOPLEGIA

378.87 OTHER DISSOCIATED DEVIATION OF EYE MOVEMENTS

378.9 UNSPECIFIED DISORDER OF EYE MOVEMENTS

379.50 NYSTAGMUS UNSPECIFIED

379.51 CONGENITAL NYSTAGMUS

379.52 LATENT NYSTAGMUS

379.53 VISUAL DEPRIVATION NYSTAGMUS

379.54 NYSTAGMUS ASSOCIATED WITH DISORDERS OF THE VESTIBULAR SYSTEM

379.55 DISSOCIATED NYSTAGMUS

379.56 OTHER FORMS OF NYSTAGMUS

379.57 DEFICIENCIES OF SACCADIC EYE MOVEMENTS

379.58 DEFICIENCIES OF SMOOTH PURSUIT MOVEMENTS

379.59 OTHER IRREGULARITIES OF EYE MOVEMENTS

379.92 SWELLING OR MASS OF EYE

431 INTRACEREBRAL HEMORRHAGE

432.0 NONTRAUMATIC EXTRADURAL HEMORRHAGE

432.1 SUBDURAL HEMORRHAGE

432.9 UNSPECIFIED INTRACRANIAL HEMORRHAGE

433.00 OCCLUSION AND STENOSIS OF BASILAR ARTERY WITHOUT CEREBRAL INFARCTION

433.01 OCCLUSION AND STENOSIS OF BASILAR ARTERY WITH CEREBRAL INFARCTION

433.10 OCCLUSION AND STENOSIS OF CAROTID ARTERY WITHOUT CEREBRAL INFARCTION

433.11 OCCLUSION AND STENOSIS OF CAROTID ARTERY WITH CEREBRAL INFARCTION

433.20 OCCLUSION AND STENOSIS OF VERTEBRAL ARTERY WITHOUT CEREBRAL INFARCTION

433.21 OCCLUSION AND STENOSIS OF VERTEBRAL ARTERY WITH CEREBRAL INFARCTION

433.30 OCCLUSION AND STENOSIS OF MULTIPLE AND BILATERAL PRECEREBRAL ARTERIES WITHOUT CEREBRAL INFARCTION

433.31 OCCLUSION AND STENOSIS OF MULTIPLE AND BILATERAL PRECEREBRAL ARTERIES WITH CEREBRAL INFARCTION

433.80 OCCLUSION AND STENOSIS OF OTHER SPECIFIED PRECEREBRAL ARTERY WITHOUT CEREBRAL INFARCTION

433.81 OCCLUSION AND STENOSIS OF OTHER SPECIFIED PRECEREBRAL ARTERY WITH CEREBRAL INFARCTION

433.90 OCCLUSION AND STENOSIS OF UNSPECIFIED PRECEREBRAL ARTERY WITHOUT CEREBRAL INFARCTION

433.91 OCCLUSION AND STENOSIS OF UNSPECIFIED PRECEREBRAL ARTERY WITH CEREBRAL INFARCTION

434.00 CEREBRAL THROMBOSIS WITHOUT CEREBRAL INFARCTION

434.01 CEREBRAL THROMBOSIS WITH CEREBRAL INFARCTION

434.10 CEREBRAL EMBOLISM WITHOUT CEREBRAL INFARCTION

434.11 CEREBRAL EMBOLISM WITH CEREBRAL INFARCTION

434.90 CEREBRAL ARTERY OCCLUSION UNSPECIFIED WITHOUT CEREBRAL INFARCTION

434.91 CEREBRAL ARTERY OCCLUSION UNSPECIFIED WITH CEREBRAL INFARCTION

435.0 BASILAR ARTERY SYNDROME

435.1 VERTEBRAL ARTERY SYNDROME

435.2 SUBCLAVIAN STEAL SYNDROME

435.3 VERTEBROBASILAR ARTERY SYNDROME

435.8 OTHER SPECIFIED TRANSIENT CEREBRAL ISCHEMIAS

435.9 UNSPECIFIED TRANSIENT CEREBRAL ISCHEMIA

436 ACUTE BUT ILL-DEFINED CEREBROVASCULAR DISEASE

437.0 CEREBRAL ATHEROSCLEROSIS

437.1 OTHER GENERALIZED ISCHEMIC CEREBROVASCULAR DISEASE

437.2 HYPERTENSIVE ENCEPHALOPATHY

437.3 CEREBRAL ANEURYSM NONRUPTURED

437.4 CEREBRAL ARTERITIS

437.5 MOYAMOYA DISEASE

437.6 NONPYOGENIC THROMBOSIS OF INTRACRANIAL VENOUS SINUS

437.7 TRANSIENT GLOBAL AMNESIA

437.8 OTHER ILL-DEFINED CEREBROVASCULAR DISEASE

437.9 UNSPECIFIED CEREBROVASCULAR DISEASE

446.5 GIANT CELL ARTERITIS

743.20 BUPHTHALMOS UNSPECIFIED

743.21 SIMPLE BUPHTHALMOS

743.22 BUPHTHALMOS ASSOCIATED WITH OTHER OCULAR ANOMALIES

743.51 VITREOUS ANOMALIES CONGENITAL

743.52 FUNDUS COLOBOMA

743.53 CHORIORETINAL DEGENERATION CONGENITAL

743.54 CONGENITAL FOLDS AND CYSTS OF POSTERIOR SEGMENT

743.55 CONGENITAL MACULAR CHANGES

743.56 OTHER RETINAL CHANGES CONGENITAL

743.57 SPECIFIED CONGENITAL ANOMALIES OF OPTIC DISC

743.58 VASCULAR ANOMALIES CONGENITAL

743.59 OTHER CONGENITAL ANOMALIES OF POSTERIOR SEGMENT

743.61 CONGENITAL PTOSIS OF EYELID

743.62 CONGENITAL DEFORMITIES OF EYELIDS

743.63 OTHER SPECIFIED CONGENITAL ANOMALIES OF EYELID

743.64 SPECIFIED CONGENITAL ANOMALIES OF LACRIMAL GLAND

743.65 SPECIFIED CONGENITAL ANOMALIES OF LACRIMAL PASSAGES

743.66 SPECIFIED CONGENITAL ANOMALIES OF ORBIT

743.69 OTHER CONGENITAL ANOMALIES OF EYELIDS LACRIMAL SYSTEM AND ORBIT

921.0 BLACK EYE NOT OTHERWISE SPECIFIED

921.1 CONTUSION OF EYELIDS AND PERIOCULAR AREA

921.2 CONTUSION OF ORBITAL TISSUES

921.3 CONTUSION OF EYEBALL

921.9 UNSPECIFIED CONTUSION OF EYE

930.0 CORNEAL FOREIGN BODY

930.1 FOREIGN BODY IN CONJUNCTIVAL SAC

930.2 FOREIGN BODY IN LACRIMAL PUNCTUM

930.8 FOREIGN BODY IN OTHER AND COMBINED SITES ON EXTERNAL EYE

930.9 FOREIGN BODY IN UNSPECIFIED SITE ON EXTERNAL EYE

950.0 OPTIC NERVE INJURY

950.1 INJURY TO OPTIC CHIASM

950.2 INJURY TO OPTIC PATHWAYS

950.3 INJURY TO VISUAL CORTEX

950.9 INJURY TO UNSPECIFIED OPTIC NERVE AND PATHWAYS

951.0 INJURY TO OCULOMOTOR NERVE

V58.69* LONG-TERM (CURRENT) USE OF OTHER MEDICATIONS

V67.51 FOLLOW-UP EXAMINATION FOLLOWING COMPLETED TREATMENT WITH HIGH-RISK MEDICATION NOT ELSEWHERE CLASSIFIED

* According to the ICD-9-CM book, diagnosis code V58.69 is a secondary diagnosis code and should not be billed as the primary diagnosis.

 

* ICD-9-CM code 362.07 requires a dual diagnosis. When using ICD-9-CM 362.07 (diabetic macular edema) a code for diabetic retinopathy (362.01-362.06) must also be used.

 

Documentation Requirements

• Medical record documentation must indicate the medical necessity for performing the test.

o In addition, documentation that the service was performed including the results of the Visual Field Examination should be available.

o This information is normally found in the office notes, progress notes, history and physical, and/or hard copy of the test results.

• If the provider of the service is other than the ordering/referring physician, the provider of the service must maintain hard copy documentation of test results and maintain hard copy documentation of test results and interpretation along with copies of the ordering/referring physician’s order for the studies.

o The physician must state the clinical indication/medical necessity for the study in this order for the test.

Treatment Logic

• The visual field is the area within which objects may be seen when the eye is fixed.

• To standardize testing, several automated and computerized perimeters are available.

• However, manual perimeters are also utilized.

 

Sources of Information and Basis for Decision

 

1998 Physician Desk Reference

 

FCSO LCD 29308, Visual Field Examination, 10/01/2011. The official local coverage determination (LCD) is the version on the Medicare coverage database at www.cms.gov/medicare-coverage-database/.

 

 

AMA CPT / ADA CDT Copyright Statement

CPT codes, descriptions and other data only are copyright 2011 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. © 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply.

 

CMS LCD L29006 Visual Field Examinations