Summary & Overview
CPT 92133: Optic Nerve Posterior Segment Imaging with Interpretation
CPT code 92133 denotes computerized diagnostic imaging of the optic nerve in the posterior segment with professional interpretation and a written report. This ophthalmic imaging procedure is used to evaluate optic nerve structure and related posterior segment pathology and is commonly performed in ophthalmology and optometry outpatient settings and imaging centers. Nationally, the code is important for quantifying utilization of structural retinal and optic nerve assessments used in glaucoma, optic neuropathy, and other posterior segment conditions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose of 92133, typical sites of service, and the range of common billing modifiers associated with professional imaging and interpretation. The publication provides benchmarks and payment context where available, highlights policy or coverage considerations relevant to imaging frequency and documentation, and summarizes clinical circumstances in which this imaging is typically used.
This summary is intended to inform billing, coding, and clinical staff, as well as policy analysts and payers, about the scope and administrative considerations for CPT code 92133 at a national level. Data not available in the input will be noted in relevant sections.
Billing Code Overview
CPT code 92133 describes computerized diagnostic imaging of the optic nerve in the posterior segment of the eye, including interpretation and a written report. The service covers imaging of one or both eyes as performed by a qualified provider.
-
Service type: Diagnostic ophthalmic imaging with interpretation and report
-
Typical site of service: Ophthalmology or optometry clinic, outpatient imaging center, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with progressive visual field loss and suspicious optic nerve cupping is referred to an ophthalmologist for evaluation. The provider obtains a computerized diagnostic imaging study of the optic nerve in the posterior segment of the eye using optical coherence tomography (OCT), performs image acquisition, interprets the data, and documents a formal report. Typical workflow: verify patient identity and indications, obtain ocular history and visual acuity, perform OCT imaging of one or both eyes, review automated RNFL and ganglion cell layer metrics, correlate imaging with clinical exam and visual field testing, generate interpretation and impression, and document findings and plan. Typical site of service is an outpatient ophthalmology or optometry clinic or an ambulatory surgical center when performed as part of pre- or post-operative assessment. Common clinical indications include glaucoma evaluation and monitoring, optic neuropathy assessment, and pre/post-operative retinal or optic nerve follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/report separate from technical imaging when the facility or separate entity bills the technical component. |
TC |