Author Topic: 92014 and 92250 what modifier?  (Read 1903 times)


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92014 and 92250 what modifier?
« on: November 11, 2015, 02:28:47 PM »
I am new to optometry and need help. I have been researching how to bill and get paid for the above codes and very confused with all the information I have come across.

when billing 92014 comp exam and 99250 fundus with dx of H40.023, Glaucoma suspect, open angle w/borderline findings, high risk. IS A MODIFIER REQUIRED AND WHICH ONE?

I have some showing TC, 26, 59, and 50 to use.

Thank you for any help you can provide.


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Re: 92014 and 92250 what modifier?
« Reply #1 on: November 14, 2015, 01:12:12 PM »

If the provider is taken the photos, and reading the results then you would not use a TC or 26 because it is global.  You also do not need the 50 modifier since the code is for both eyes.  The 59 modifier is used if you are trying to indicating that it is a distinct procedural service.  I can't tell you whether or not to use it, simply to get a service paid, however most insurance carriers consider the 92250 as a distinct service without any modifiers.
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Re: 92014 and 92250 what modifier?
« Reply #2 on: January 26, 2016, 01:23:51 PM »
With the information you've given, no modifier is required.