CPT 92145: Corneal Deformation Measurement with Metered Air Impulses

CPT code 92145 documents a diagnostic corneal deformation measurement in which metered air impulses are applied to the cornea to measure inward and outward movement; the clinician interprets results and produces a report. This measurement is used in assessing corneal biomechanical properties relevant to glaucoma risk assessment, refractive surgery planning, and other ophthalmic diagnostic evaluations, making it clinically significant across outpatient eye care nationally.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national perspective on coverage patterns, clinical indications, and typical sites of service for this diagnostic procedure.

Readers will learn the clinical context and procedural definition of CPT code 92145, expected service settings, and the role the measurement plays in eye care workflows. Where available, the report summarizes common billing practices, reimbursement benchmarks, and relevant policy updates that affect outpatient ophthalmology diagnostic services. Data not available in the input is noted where specific payer policy language, associated taxonomies, or ICD-10 diagnosis mappings are required.

Billing Code Overview

CPT code 92145 describes a diagnostic eye procedure in which the provider applies metered air impulses to the cornea and measures the difference in inward and outward corneal movement. The provider then interprets the measurement data and completes a report of the findings.

Service Type: Diagnostic ocular biomechanics / corneal deformation measurement

Typical Site of Service: Ophthalmology clinic, optometry clinic, or eye specialty center (office or outpatient setting)

Clinical Context

A patient presents to an ophthalmology clinic complaining of fluctuating vision and halos around lights. The patient is evaluated by an optometrist or ophthalmologist who performs a non-contact tonometry test using a pneumatic (air-puff) tonometer to measure corneal deformation and estimate intraocular pressure and corneal biomechanics. The procedure involves applying metered air impulses to one or both corneas, recording inward and outward corneal movement, interpreting the resulting waveform/measurements, and completing a written report. Typical workflow: patient intake and history, visual acuity and slit-lamp exam as indicated, explanation of the test, performance of the pneumatic tonometry (one or both eyes), capture of data and quality checks, interpretation by the provider, and documentation including the formal report. Typical site of service is an outpatient ophthalmology or optometry clinic, ambulatory surgical center when performed as preoperative testing, or hospital outpatient department when required for inpatient ophthalmic evaluation. Typical patient scenario includes preoperative evaluation for refractive surgery or cataract surgery, glaucoma suspect assessment, ocular hypertension monitoring, or corneal disease evaluation where corneal biomechanics are relevant to care decisions.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the physician interpretation/report is billed separately and the technical component is performed by another entity.

Taxonomy Code	Specialty	Notes
207W00000X	Ophthalmology	Board-certified ophthalmologists commonly perform and interpret this test, especially for glaucoma and preoperative assessment.
152V00000X	Optometry	Optometrists frequently perform pneumatic tonometry in outpatient clinics for routine eye exams and pressure screening.
363LA2200X	Ophthalmic Medical Technician	Technicians often operate the tonometer and acquire images/data; interpretation is by the licensed provider.
2080P0206X	Cornea Specialist (Ophthalmology sub-specialty)	Cornea specialists use corneal deformation measurements for corneal biomechanics assessment and surgical planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H40.0`	Glaucoma suspect (historical coding approximate grouping)	Used when intraocular pressure concerns or optic nerve changes prompt corneal deformation testing as part of glaucoma risk assessment.
`H40.1`	Primary open-angle glaucoma	Corneal biomechanics and IOP estimation inform monitoring and management decisions.
`H52.4`	Presbyopia	Preoperative and refractive assessments may include corneal deformation testing when planning corrective procedures.
`H18.5`	Keratoconus	Corneal deformation analysis assists in detecting ectatic changes and surgical planning.
`H21.9`	Disorder of iris and ciliary body, unspecified	May accompany complex anterior segment evaluations where corneal biomechanics are relevant.
`Z98.2`	Presence of intraocular lens	Pre- and post-operative corneal assessments are performed in pseudophakic patients for visual complaints.
`H44.2`	Degenerative myopia	High myopia patients undergoing refractive or cataract surgery benefit from corneal biomechanics assessment for risk stratification.
`Z01.00`	Encounter for examination of eyes and vision without abnormal findings	Screening or routine exams where corneal deformation testing is included in diagnostic workup.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`92145`	Electronic or computerized corneal deformation analysis (pneumotonometry) with interpretation and report	This is the primary code describing measurement of corneal inward and outward movement with air impulses and interpretation/reporting.
`92100`	Ophthalmological diagnostic evaluation (e.g., tonometry)	General tonometry may be performed alongside or prior to computerized corneal deformation testing for baseline intraocular pressure comparison.
`92015`	Determination of refractive state	Performed in the same visit when visual function and refractive status are being assessed for surgical planning.
`92136`	Ophthalmic ultrasound, diagnostic; immersion B-scan and interpretation and report	Performed when additional posterior segment assessment is needed in complex cases; complements corneal testing when globe pathology is suspected.
`76514`	Corneal topography, unilateral or bilateral, with interpretation and report	Often performed alongside corneal deformation analysis to evaluate corneal shape and for preoperative mapping and keratoconus screening.

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Summary & Overview