CPT 92014: Eye Exam, Established Patient, Comprehensive
Ophthalmological services: medical examination and evaluation with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1+ visits.
Why CPT 92014 Claims Get Denied
Claims billed under CPT 92014 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.
Documentation does not support comprehensive level
Billed on same date as general E/M
Frequency exceeds payer guidelines
Missing medical diagnosis
Billing Tips for CPT 92014
Must include comprehensive history, general medical observation, external and ophthalmoscopic examination, gross visual fields and basic sensorimotor examination. Cannot be billed with general E/M on same date. Use medical diagnosis codes for payer coverage.
Documentation Requirements
To support a clean claim for CPT 92014, your clinical documentation should include:
Comprehensive ophthalmic history
External examination
Slit lamp biomicroscopy
Dilated funduscopy
Tonometry
Visual acuity
Diagnosis and treatment plan
Common Modifiers for CPT 92014
Reduce CPT 92014 Denials by 60%
RediClaim's pre-submission scrubber catches documentation gaps and coding errors before you submit, while the appeal generator handles denials that slip through.