CPT® Code 92014

Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits

A comprehensive level of general ophthalmological services is provided to an established patient within the course of one or more visits, as indicated by CPT® Code 92014. This code encompasses a thorough medical examination and evaluation of the patient's visual system, which does not need to be completed in a single session. The comprehensive evaluation includes a detailed history or interval history, along with general medical observations that are crucial for understanding the patient's overall health and visual status. The examination involves an external ocular and adnexal assessment, which covers the eyelids, eyelashes, eyebrows, eye alignment and motility, conjunctiva, cornea, and iris. Additionally, the use of a slit lamp is integral to this evaluation, allowing for a more in-depth examination of the anterior segment of the eye. The assessment also includes testing the gross visual field or visual acuity of each eye, sensorimotor examination, and routine ophthalmoscopy to inspect the ocular media, retina, and optic nerve. Tonometry is performed on established patients, particularly for those with known conditions such as cataracts, to measure intraocular pressure. Other diagnostic techniques such as keratometry, retinoscopy, and biomicroscopy are utilized, especially in cases of acute or complicated conditions. To facilitate a comprehensive examination, mydriatic agents may be employed to dilate the pupils, enhancing the visualization of the ocular media and fundus. Cycloplegic agents are also used to temporarily paralyze the ciliary muscle, aiding in the assessment of accommodation. Following the diagnostic evaluation, the physician has the option to initiate a new diagnostic treatment program or continue an existing one, which may involve prescribing medications, arranging for additional special services, consultations, laboratory tests, or radiology services as necessary.