CPT Code 92002: Intermediate Eye Exam, New Patient
Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
CPT 92002 reports an intermediate eye examination for a new patient. It covers evaluation of a new or existing condition complicated by a new diagnostic or management problem, requiring history, general medical observation, external ocular and adnexal examination, and other diagnostic procedures as indicated. Does not require the comprehensive elements of 92004.
When to use CPT 92002
Use CPT 92002 for a new patient with a specific problem (red eye, foreign body, minor trauma) that does not require a full comprehensive exam. Must include initiation of a diagnostic and treatment program.
Documentation requirements
- New patient
- Chief complaint and history
- External ocular and adnexal examination
- Other diagnostic procedures as indicated
- Initiation of diagnostic and treatment program
Reimbursement
$65 to $95
National averages only. Rates vary by locality, payer, and fee schedule. Verify with your contracted payers.
Common modifiers
- -25
- -57
Common denial reasons for CPT 92002
- Comprehensive exam performed instead
- Patient not actually new
- Missing treatment initiation
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