Summary & Overview
CPT 92019: Limited Eye Examination Under General Anesthesia
CPT code 92019 designates a limited ophthalmologic examination performed while the patient is under general anesthesia, often used for children or patients unable to cooperate with in-office exams. It enables clinicians to assess conditions such as glaucoma, retinal abnormalities, or intraocular tumors when standard awake examination is not feasible. Nationally, use of this code matters for access to diagnostic eye care in pediatric and special-needs populations and for accurate procedural reporting when anesthesia is required.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical intent and typical settings, plus benchmarking and coverage patterns across major payers. The publication summarizes common billing modifiers and related administrative considerations, highlights where policy updates may affect authorization or bundling with anesthesia services, and provides clinical context for appropriate use of a limited exam under anesthesia.
This resource is intended to help coding managers, billing professionals, and clinical leaders understand when CPT code 92019 is reported, the typical sites of service, and the payer landscape affecting claims processing and coverage decisions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92019 describes a limited eye examination performed with the patient under general anesthesia. The procedure is used when a patient — commonly a child or an individual unable to cooperate with a standard eye exam — requires assessment of ocular conditions while anesthetized. The provider may perform passive manipulation of the globe to assess range of motion or to facilitate diagnostic visualization.
Service type: Diagnostic eye examination under general anesthesia
Typical site of service: Operating room or other procedural suite where general anesthesia is administered
Clinical & Coding Specifications
Clinical Context
A typical scenario involves a pediatric patient or an adult unable to cooperate for an awake ophthalmic exam who is scheduled for a limited diagnostic eye examination under general anesthesia using 92019. For example, a 3-year-old with suspected congenital glaucoma and developmental delay is brought to the operating room. After induction of general anesthesia by the anesthesia team, the ophthalmologist performs an abbreviated eye exam: external inspection, intraocular pressure assessment with handheld tonometry if feasible, evaluation of the anterior segment, and limited indirect ophthalmoscopy. The provider may gently manipulate the globe passively to assess extraocular motion or to improve visualization of the retina. Documentation includes anesthesia start and stop times, indications (e.g., suspected glaucoma, poor cooperation), findings (tonometry value, corneal/clouding findings, retina status), and any diagnostic maneuvers performed. The typical site of service is an operating room, ambulatory surgery center, or procedure suite where general anesthesia is administered and monitored by qualified anesthesia personnel. Common clinical workflow steps: preoperative assessment and consent, anesthesia induction, ophthalmic limited exam under anesthesia with documented findings, communication of results to family, and postoperative recovery and discharge or admission as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia — non‑surgical |