92014

🩺 CPT Code 92014 - Comprehensive Eye Exam (Established)

Description & Explanation: This code is for a comprehensive medical examination and evaluation of the eyes for an established patient.

• Comprehensive: Must include a general medical observation, chief complaint, history, and a detailed examination of the external eye and adnexa, ophthalmoscopy (dilation is usually required but not strictly mandated if contraindicated), and gross visual fields.

• Established: The patient has been seen by the same physician/specialty/group within the last 3 years.

• It usually involves the initiation or continuation of a diagnostic and treatment program (e.g., prescribing glasses/medication is not strictly required, but the program must be managed).

Code Tree:

• Medicine

  • Ophthalmology

    • General Ophthalmological Services

      • 92014: Comprehensive eye exam, established patient

Technical Data:

• WRVU (2025): ~1.42

• Global Period: XXX

• Assistant Payable: No

• HCC Information: N/A

Bundling & Edits:

• Included: Slit lamp exam, ophthalmoscopy, gross visual fields, basic sensorimotor exam.

• Excluded (Bill Separately):

  • Refraction (92015).

  • Formal visual field tests (92081-92083).

  • OCT (92133/92134).

  • Fundus photography (92250).

• Mutually Exclusive: E/M codes (99212-99215) on the same day (usually you pick the one that best describes the service, though some payers allow E/M for a separate systemic issue with Modifier 25).

Clinical Examples:

1. Annual Diabetic Eye Exam: An established patient with Type 2 Diabetes presents for their annual dilated fundus exam. No retinopathy found.

2. Cataract Evaluation: Patient complains of blurred vision. Comprehensive exam reveals worsening cataracts. Surgical options discussed.