HCPCS and Diagnosis Coding

70.1.1 - HCPCS and Diagnosis Coding (Rev. 3329, Issued: 08-14-15, Effective: 01-01-12, Implementation: 09-14-15) The following HCPCS codes should be reported when billing for screening glaucoma services: G0117 - Glaucoma screening for high-risk patients furnished by an optometrist (physician for A/B MAC (B)) or ophthalmologist. G0118 - Glaucoma screening for high-risk patients furnished under the direct supervision of an optometrist (physician for A/B MAC (B) or ophthalmologist. The A/B MAC (B) claims type of service for the above G codes is: TOS Q. Glaucoma screening claims should be billed using screening (“V”) code V80.1 (Special Screening for Neurological, Eye, and Ear Diseases, Glaucoma), or if ICD-10-CM is applicable, diagnosis code Z13.5 (encounter for screening for eye and ear disorders). Claims submitted without a screening diagnosis code may be returned to the provider as unprocessable (refer to chapter 1 of this manual for more information about incomplete or invalid claims).