New Codes for Glaucoma Screening Services

The Benefits Improvements and Protection Act (BIPA) of 2000, Section 102, provides annual coverage for glaucoma screening for eligible Medicare beneficiaries, i.e., those with diabetes mellitus or a family history of glaucoma, and certain other individuals found to be at high risk for glaucoma.

Medicare will pay for glaucoma screening examinations when they are furnished by or under the direct supervision of an ophthalmologist or optometrist who is legally authorized to perform the services under state law.

Screening for glaucoma is defined to include: (1) a dilated eye examination with an intraocular pressure measurement, and (2) a direct ophthalmoscopy examination, or a slit-lamp biomicroscopic examination. Medicare will pay for a glaucoma screening examination performed on an eligible beneficiary on or after Jan. 1, 2002, and after at least 11 months have passed following the month in which the last covered glaucoma screening examination was performed.

Submit claims for glaucoma screening services to Medicare using the screening "V" code V80.1.

Effective for date(s) of service on or after Jan. 1, 2002, the new codes are:

 

G0117

Glaucoma screening for high-risk patients furnished by a physician.

G0118

Glaucoma screening for high-risk patients furnished under the direct supervision of a physician.

Covered for:

 

V80.1

Special screening for neurological, eye and ear disease, glaucoma.

 

 

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