CPT 92015 describes refraction and any necessary prescription of lenses. Refraction is not separately reimbursed as part of a routine eye exam or as part of a medical examination and evaluation with treatment/diagnostic program.Click to see full answer. Also to know is, is CPT 92015 covered by Medicare?Refraction (CPT code 92015) has been a “non-covered” service since Medicare was created in 1965. Since about 2007, Medicare has been enforcing the policy of requiring eye doctors to charge separately for refractions.Similarly, does Medicare pay for CPT code 92014? No 92014 for Routine Checks on Medicare Patients. Code 92014 is often used for routine checks when the patient does not have a sign, symptom, complaint or known diagnostic condition for which the physician recommended a re-check. It may be correct for that service, but the service will not be covered by Medicare. Keeping this in view, why is refraction not covered by insurance? The charges for a refraction are covered by some insurances but not all. For example, Medicare does not cover refractions because they consider it part of a “routine” exam and Medicare doesn’t cover most “routine” procedures – only health-related procedures.How do you bill a diabetic eye exam? CPT codes 92002 through 92004, and CPT codes 92012 and 92014 When billing for an ophthalmological evaluation and dilated eye exam for patients with diabetes, consider using ophthalmological service codes. These codes describe the evaluation of new or existing conditions of the eye only.
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