Billing for the GDX

• Remember to always fill in the referring doctor (block 17). If no referral is needed for insurance then put yourself as the referring doctor.
• The doctor does not need to be present the day of the visit. We can do all the scans on one date and the patient can be seen on another for the visit (99213) if needed.
• To bill the GDx use the new code 92133 with no modifiers required. This is now a bilateral code! The old 92135 code is no longer valid!
• When billing Medicare you cannot bill other procedures same day as with the visit (92xxx, 99xxx,etc.) and 92133 (GDx scan). All additional procedures may be denied.
• When considering referrals follow same rules as visual fields (92083). If a referral is needed for a visual field then a referral will be needed for a GDx.
• Most insurances will cover up to 2 GDx scans per calendar year if medical necessity warrants. It is more common to perform a GDx (92133) once per calendar year and also a visual field (92083) once per calendar year. Many practitioners have adapted seeing the patient every 6 months and alternating the tests (Visual Field 6months-GDx 6 months-Visual Field 6 months-GDx and so on).

REMEMBER THERE IS NO NEED FOR MODIFIERS (RT & LT)
EXAMPLE:

• Currently most insurances are covering for the testing including TUFTS. Please contact your insurance companies to confirm coverage and reimbursement.
• Our rental fee is expected on the same day as service rendered.
  

If there are any further questions please don’t hesitate to call at 774-222-3235.

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