CPT Code 92012: Intermediate Eye Exam, Established Patient
Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
CPT 92012 reports an intermediate eye examination for an established patient. Similar scope to 92002 but for patients already in your practice within the last 3 years.
When to use CPT 92012
Use CPT 92012 for an established patient with a focused or minor problem (red eye, Rx recheck, stable condition follow-up) not requiring a full comprehensive exam.
Documentation requirements
- Established patient
- Chief complaint and interval history
- External ocular and adnexal examination
- Diagnostic procedures as indicated
- Continuation or initiation of treatment program
Reimbursement
$50 to $80
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 92012
- Comprehensive exam was actually performed
- Missing medical necessity
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