CPT 92002Intermediate 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
Use the current payer fee schedule for this code, locality, service setting and date of service.
Rates and patient responsibility depend on the payer and service. No unsourced national average is presented here.
Common modifiers
- -25
- -57
Common denial reasons for CPT 92002
- Comprehensive exam performed instead
- Patient not actually new
- Missing treatment initiation
Verify CPT 92002 against official sources
Use the code set and payer policy applicable to the date of service. This educational reference is not a coverage decision or a substitute for a qualified coding review.
- CMS Physician Fee Schedule: select the year, locality and service setting before looking up payment information.
- CMS NCCI edits and manuals: check the applicable code-pair edits and modifier instructions.
- Medicare Coverage Database: find relevant coverage and documentation policies.
- AMA CPT resources: consult the current licensed code set.
A practical documentation check
- Match the documented service to the code definition.
- Confirm patient status, laterality, components and any required interpretation.
- Check coverage, edits and payer-specific requirements.
- Have the responsible clinician or billing reviewer resolve discrepancies before submission.
Editorial sources updated September 15, 2026. Published by Jelo.
Jelo’s AI scribe is an upcoming add-on from $70/month. It is being developed to assist with documentation and code suggestions; clinicians and billing staff must verify every code. It is not included in the live platform subscription.
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