Is CPT code 92134 covered by Medicare?
Asked by: Colt Mohr | Last update: November 13, 2025Score: 4.3/5 (46 votes)
Is CPT 92134 covered by Medicare?
CPT Code 92134 Medicare Reimbursement. CPT code 92134, which refers to "Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral," is reimbursed by Medicare.
What chiropractic CPT codes are covered by Medicare?
Diagnosis Code Description Medicare Covered Chiropractic Services If the CPT code is 98940, 98941, or 98942 and is billed with one of the following diagnosis codes and with modifier AT, then the chiropractic service is covered.
Does Medicare cover optical coherence tomography?
Medicare covers posterior OCT if the patient presents with a complaint that leads you to perform this test or as an adjunct to management and treatment of a known disease.
How often can a CPT code 92134 be billed?
CPT code 92134 may not be reported more than one (1) time every two (2) months.
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Are 92134 and 92250 bundled?
SCODI (92133, 92134) and fundus photography (92250) are mutually exclusive codes. However, there may be a limited number of clinical situations in which it is necessary to perform both techniques in order to evaluate and treat the patient.
Can 92132 and 92134 be billed together?
Correct Coding Initiative edits state that code 92132 can't be billed the same day as either 92133 Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve or 92134 Scanning computerized ophthalmic diagnostic imaging, posterior segment, ...
What eye test is not covered by Medicare?
Eye exams (routine)
Medicare doesn't cover eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses.
What is the Medicare item number for optical coherence tomography?
Medicare item 11219: Optical coherence tomography (OCT)
Does Medicare A and B cover CT scans?
Medicare covers CT scans when medically necessary. Medicare Part A will cover the costs if a person stays in the hospital, hospice, or skilled nursing facility as an inpatient. Medicare Part B covers a scan when a person receives it as an outpatient.
What CPT codes are not covered by Medicare?
Certain services are never considered for payment by Medicare. These include preventive examinations represented by CPT codes 99381-99397. Medicare only covers three immunizations (influenza, pneumonia, and hepatitis B) as prophylactic physician services.
Why does Medicare not pay for chiropractor?
Medicare Part A (hospital insurance) only pays for emergency procedures and hospital care. So chiropractors, who typically work in private offices or clinics, will not be covered. Medicare Part B (medical insurance) will cover spinal manipulation that is needed to correct a subluxation.
How much does Medicare pay for a chiropractic adjustment?
You will pay a 20 percent coinsurance for a chiropractic visit. Medicare Part B pays the other 80 percent of the Medicare-approved amount. The Part B deductible applies. Your costs may be different with a Medicare Advantage plan so be sure to talk with your plan provider directly.
Does Medicare have optical coverage?
Original Medicare ( Part A and Part B ) doesn't cover eye exams or other vision-related costs, except for special situations. However, some people on Medicare have options, including vision coverage through individual insurance or Medicare Advantage plans (Part C) with vision coverage.
What is the CPT code for optical coherence tomography?
CPT codes 92132, 92133 and 92134 have been revised. Codes 92132 and 92133 have been revised to add optical coherence tomography (OCT) to the descriptor. 92132, 92133 and 92134 and instructions for reporting have been updated to stay current with how practices are evolving.
Can you get 92133 and 92134 on the same day?
Question: Can we bill for both CPT codes 92133 SCODI optic nerve and 92134 SCODI retina if we have two different diagnoses? Answer: No. These two scans are mutually exclusive of each other and cannot be unbundled. CPT language also states that both tests can't be billed on the same day.
Does Medicare pay for 92134?
Claims for SCODI services (CPT codes 92133 and 92134) are payable under Medicare Part B in the following places of service: The global service is payable in the office (11), nursing facility (32- for Medicare patient not in a Part A stay) and independent clinic (49).
Is optical coherence tomography expensive?
The vast majority of new OCT machines provide this as standard. But if you're investing in a refurbished machine, it's worth checking this. OCT machines range from approximately £5,000 for a refurbished machine through to £70,000+ which is a considerable investment.
What are Medicare covered diagnostic radiology services?
Medicare generally covers: X-rays, including portable x-rays; Computerized Axial Tomography (CAT) procedures, including portable CT procedures; (MRI) procedures; Magnetic Resonance Angiography (MRA) procedures; Nuclear Medicine Imaging procedures and radionuclides used in the procedures; Diagnostic mammography and ...
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
How much is an eye exam without insurance?
The cost of an eye exam can vary widely depending on factors such as location, the types of tests that are performed, and whether you have vision insurance. Without insurance, you can expect to pay between $50 and $200 for a standard eye exam.
Why is eye care not covered by insurance?
Since the passage of the Affordable Care Act (ACA) vision insurance has been phased into the health care marketplace, but because oral and vision care aren't considered essential health services, these policies are offered separately from a person's health care plan.
What is the ICD 10 code for optical coherence tomography?
2025 ICD-10-PCS Procedure Code B221Z2Z: Computerized Tomography (CT Scan) of Multiple Coronary Arteries using Intravascular Optical Coherence.
How often can you bill for pachymetry?
Pachymetry is a once in a lifetime benefit for glaucoma diagnosis. The only way Medicare would pay for additional pachymetries would be if they were completed for other, unrelated diagnoses.
Does 92132 need a modifier?
Does CPT 92132 Need a Modifier? For CPT code 92132 (Computerized ophthalmic diagnostic imaging, anterior segment), the application of modifiers can be essential depending on the specific billing circumstances and payer requirements.