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92132

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đź©ş CPT Code 92132: Documentation & Billing Guide

Ophthalmic diagnostic imaging of the anterior segment using optical coherence tomography, with interpretation and report

Short Definition

Scanning computerized ophthalmic diagnostic imaging of the anterior segment using optical coherence tomography with interpretation and report, unilateral or bilateral

Long Definition

CPT code 92132 describes computerized ophthalmic diagnostic imaging of the anterior segment of the eye using optical coherence tomography technology. This non-invasive imaging technique provides high-resolution cross-sectional images of the anterior ocular structures including the cornea, anterior chamber, iris, and angle structures. The procedure is performed to evaluate corneal pathology, anterior chamber depth and angle anatomy for glaucoma assessment, and other anterior segment abnormalities.

The code includes image acquisition, interpretation by a physician, and a written report. The service may be performed unilaterally or bilaterally with one unit billed regardless of laterality.

Area of Body

Anterior segment of the eye, including:

  • Cornea (all layers: epithelium, Bowman’s layer, stroma, Descemet’s membrane, endothelium)

  • Anterior chamber and anterior chamber angle

  • Iris and iris root

  • Ciliary body (anterior portion)

  • Crystalline lens (anterior surface)

  • Trabecular meshwork

  • Schlemm’s canal

  • Scleral spur

Service Components

Included Services:

  • Image acquisition of anterior segment structures

  • Technical component (equipment operation and image capture)

  • Professional component (physician interpretation and report)

  • Written report documenting findings

  • Bilateral imaging when performed (both eyes included in single unit)

  • Multiple scans during same session to optimize image quality

  • Comparison to prior imaging when available

Excludes:

  • Posterior segment OCT imaging (use 92133 for optic nerve, 92134 for retina, or 92137 for retina with OCT angiography)

  • Specular microscopy and endothelial cell analysis (use 92286)

  • Tear film imaging (use 0330T)

  • Ultrasound biomicroscopy (use 76513)

  • Corneal pachymetry alone (use 76514)

  • Gonioscopy (use 92020)

  • Same-day posterior segment OCT codes 92133, 92134, or 92137 (bundled in NCCI, though may be appropriate when medically necessary)

Includes:

  • Assessment of corneal thickness and layer differentiation

  • Anterior chamber depth measurement

  • Angle structure visualization and assessment

  • Iridocorneal angle evaluation

  • Post-surgical evaluation (corneal transplant, refractive surgery, glaucoma surgery)

RVU Information

Work RVU (wRVU): 0.45
Facility Total RVU: Approximately 0.73
Non-Facility Total RVU: Approximately 1.32
Global Days: XXX (diagnostic test, no global period)
Medicare Status: Active/Payable
2026 Medicare National Average: Approximately $42-45 (varies by locality)

RVU Note: RVUs for OCT codes were revised in 2025 with slight reductions from previous years. Code 92132 is designated as Designated Health Service under Stark Law.

HCC Status

Not Applicable - HCC coding applies only to ICD-10 diagnosis codes, not CPT procedure codes

Assistant Surgeon Status

Assistant Payable: No
CPT 92132 is a diagnostic imaging service, not a surgical procedure. Assistant surgeon modifiers (80, 81, 82, AS) are not applicable or payable for diagnostic testing services.

Common Modifiers

ModifierDescriptionUsageNotes
-26Professional component onlyModerateWhen interpretation only is performed without owning equipment
-TCTechnical component onlyModerateWhen only the equipment/acquisition is provided without interpretation
-59Distinct procedural serviceLowRarely needed; may be required by some payers when billing with certain procedures
-76Repeat procedure by same physicianLowWhen repeat imaging same day is medically necessary
-77Repeat procedure by different physicianRareWhen different provider repeats imaging
-RTRight sideNot typicalGenerally not used as code includes bilateral service
-LTLeft sideNot typicalGenerally not used as code includes bilateral service
-52Reduced servicesRareWhen full service cannot be completed
-GYStatutorily excludedLowWhen service not covered by Medicare
-GAWaiver of liability on fileLowWhen ABN obtained for non-covered service

Common Associated CPT Codes

CPT CodeDescriptionClinical ContextBilling Notes
92020GonioscopyAngle closure evaluationCan bill same day, different technique
92002Intermediate eye exam, new patientInitial evaluationTypically same encounter
92004Comprehensive eye exam, new patientComplete evaluationTypically same encounter
92012Intermediate eye exam, establishedFollow-up visitsCommonly billed together
92014Comprehensive eye exam, establishedComplete follow-upCommonly billed together
92133OCT posterior segment, optic nerveWhen both anterior/posterior imaging neededCan bill same day per CPT guidelines
92134OCT posterior segment, retinaWhen both anterior/posterior imaging neededCan bill same day per CPT guidelines
76514Corneal pachymetryCorneal thickness measurementMay be separately billable
92286Specular microscopyEndothelial cell countDifferent technology, separately billable
65222Removal of foreign body, cornealCorneal foreign bodyOCT may help localize
66170TrabeculectomyGlaucoma surgeryPost-op imaging
66174Transluminal dilation of aqueous outflow canalMIGS procedurePost-op assessment
66183Aqueous shunt insertionGlaucoma surgeryPre-op and post-op imaging
65710Keratoplasty, penetratingCorneal transplantPost-op monitoring

Code Tree/Hierarchy

CPT Manual Section: Medicine (90000-99999)
Subsection: Ophthalmology (92002-92499)
Major Category: Special Ophthalmological Services (92018-92499)
Subcategory: Other Specialized Services (92065-92145)
Service Type: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

Code Family - OCT Imaging:

Scanning Computerized Ophthalmic Diagnostic Imaging 
├── Anterior Segment OCT │   
└── 92132 (Anterior segment) ◄ Current Code 
	└── Posterior Segment OCT     
		├── 92133 (Optic nerve)    
		├── 92134 (Retina)    
		└── 92137 (Retina with OCT angiography)

Historical Context:

  • Prior to 2011: Code 92135 (OCT one or more sessions)

  • 2011: Split into 92132 (anterior), 92133 (optic nerve), 92134 (retina)

  • 2025: Code descriptions revised; 92137 added for OCTA

  • Billing changed from per-eye to per-encounter payment

Coding Examples

Example 1: Narrow Angle Glaucoma Suspect

Clinical Scenario: 62-year-old female with hyperopia referred for narrow angles noted on routine examination. Patient reports halos around lights at night.

Services Performed:

  • Comprehensive ophthalmological examination

  • Gonioscopy showing narrow angles with grade 2 by Shaffer classification

  • Anterior segment OCT performed to quantify angle opening distance and trabecular-iris space area

  • OCT findings: Anterior chamber depth 2.3mm OD, 2.4mm OS; narrow angles 360 degrees both eyes with iris insertion anterior to scleral spur

Coding:

  • 92014 - Comprehensive eye exam, established patient (or 92004 if new)

  • 92132 - Anterior segment OCT

  • 92020 - Gonioscopy

  • H40.063 - Primary angle closure suspect, bilateral

Documentation Notes:

Report should detail angle parameters, anterior chamber depth, iris configuration, and comparison to normative database if available.

Example 2: Post-LASIK Corneal Ectasia

Clinical Scenario: 35-year-old male 5 years post-LASIK with progressive vision decline and irregular astigmatism. Suspected post-LASIK ectasia.

Services Performed:

  • Detailed examination with refraction showing irregular astigmatism

  • Corneal topography showing inferior steepening

  • Anterior segment OCT to evaluate corneal thickness, anterior/posterior elevation, and assess for ectatic changes

  • Findings: Focal thinning inferior cornea OD, minimum thickness 398 microns, posterior elevation suggesting early ectasia

Coding:

  • 92012 or 92014 - Eye examination

  • 92132 - Anterior segment OCT

  • 92015 - Refraction

  • 92025 - Computerized corneal topography (if performed)

  • H18.711 - Corneal ectasia, right eye

  • Z98.890 - Other specified postprocedural states

Example 3: Fuchs Endothelial Dystrophy Monitoring

Clinical Scenario: 58-year-old female with known Fuchs endothelial dystrophy, monitoring progression to determine timing of endothelial keratoplasty.

Services Performed:

  • Comprehensive eye examination

  • Assessment of corneal edema and visual symptoms

  • Anterior segment OCT to measure corneal thickness and evaluate epithelial and stromal edema

  • Specular microscopy for endothelial cell count

  • Findings: Central corneal thickness 625 microns OD, 618 microns OS with stromal edema; endothelial cell count 850 cells/mm²

Coding:

  • 92014 - Comprehensive eye exam, established

  • 92132 - Anterior segment OCT

  • 92286 - Specular microscopy with endothelial cell analysis

  • H18.13 - Fuchs’ endothelial dystrophy, bilateral

Example 4: Post-Trabeculectomy Bleb Assessment

Clinical Scenario: 68-year-old male 6 weeks post-trabeculectomy with rising intraocular pressure. Assess bleb function and internal ostium patency.

Services Performed:

  • Post-operative examination

  • IOP measurement: 22 mmHg OD

  • Slit lamp examination of filtering bleb

  • Anterior segment OCT to evaluate bleb morphology, internal ostium patency, and anterior chamber depth

  • Findings: Flat, fibrotic bleb; OCT shows closed internal ostium with encapsulation

Coding:

  • 99024 - Postoperative follow-up visit (if within global period, no charge) OR

  • 92012 - Intermediate eye exam with modifier 24 (if separately identifiable and documented)

  • 92132 - Anterior segment OCT (separately billable with modifier if appropriate)

  • H40.1410 - Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified

  • Z98.89 - Other specified postprocedural states

Note

If within 90-day global period of trabeculectomy, OCT imaging may be separately billable but examination typically included in surgical global package.

Example 5: Anterior Chamber Intraocular Lens Assessment

Clinical Scenario: 72-year-old aphakic patient previously underwent intracapsular cataract extraction years ago, now considering anterior chamber IOL placement. Preoperative evaluation of anterior chamber depth and angle structures.

Services Performed:

  • Comprehensive pre-operative evaluation

  • Measurements for anterior chamber IOL

  • Anterior segment OCT to assess anterior chamber depth, angle width, iris integrity, and corneal endothelium

  • Findings: Adequate anterior chamber depth 3.2mm, open angles, healthy endothelium

Coding:

  • 92004 or 92014 - Eye examination

  • 92132 - Anterior segment OCT

  • 92136 - Ophthalmic biometry (if IOL calculations performed)

  • Z01.00 - Encounter for examination of eyes and vision without abnormal findings

  • Q13.1 - Absence of lens (aphakia), acquired

Example 6: Corneal Transplant Rejection Monitoring

Clinical Scenario: 45-year-old female 18 months post-penetrating keratoplasty (PK) presenting with decreased vision and photophobia. Rule out graft rejection.

Services Performed:

  • Detailed examination showing corneal stromal haze and epithelial irregularity

  • Anterior segment OCT to evaluate graft-host interface, assess for interface fluid, measure graft thickness, and evaluate for rejection line

  • Findings: OCT shows diffuse graft edema with increased stromal thickness, hyperreflective interface

Coding:

  • 92012 or 92014 - Eye examination (depending on complexity)

  • 92132 - Anterior segment OCT

  • T86.841A - Corneal transplant rejection, initial encounter (or D for subsequent)

  • Z94.7 - Corneal transplant status

Documentation Requirements

To support CPT 92132, medical record documentation must include:

Medical Necessity:

  • Clinical indication for anterior segment imaging

  • Symptoms or findings prompting the test

  • How results will affect patient management

Interpretation Report Must Contain:

  • Patient demographics and date of service

  • Indication for the study

  • Description of imaging technique and area scanned

  • Quality of images obtained

  • Quantitative measurements when applicable:

    • Corneal thickness (central and peripheral if relevant)

    • Anterior chamber depth

    • Angle parameters (angle opening distance, trabecular-iris space area)

    • Iris thickness

  • Qualitative findings:

    • Corneal layer architecture

    • Angle configuration

    • Iris configuration

    • Anterior chamber structures

    • Abnormalities identified

  • Comparison to prior studies when available

  • Clinical correlation

  • Impression/conclusion

  • Physician signature and credentials

Image Documentation:

  • Images must be stored in patient record or PACS system

  • Key images showing relevant findings should be available

  • Images should be of diagnostic quality

Billing Guidelines and Best Practices

Bilateral vs Unilateral:

  • Bill one unit whether performed unilaterally or bilaterally

  • Do NOT use modifier 50 (bilateral)

  • Do NOT bill with RT/LT modifiers for each eye

  • Use quantity “1” regardless of number of eyes imaged

  • This differs from historical billing prior to 2011

Professional vs Technical Component:

  • Global service includes both technical and professional components

  • If splitting components, use modifier 26 (professional) or TC (technical)

  • Physician interpretation must be documented with report for professional component

  • Technical component requires equipment ownership/operation and image acquisition

Frequency and Medical Necessity:

  • Must be medically necessary; routine screening not typically covered

  • Frequency depends on clinical condition being monitored

  • Document reason if performing more frequently than typically expected

  • Medicare and commercial payers may have frequency limitations

NCCI Edits and Bundling:

  • Can bill with 92133 or 92134 on same date when medically necessary

  • Generally not bundled with examination codes (92002-92014)

  • May have edits with other anterior segment procedures

  • Check current NCCI edits before billing multiple codes same date

Designated Health Service (DHS):

  • CPT 92132 is on CMS Stark Law DHS list as of 2025

  • Physicians with ownership in imaging equipment must comply with Stark regulations

  • Must meet exception requirements for self-referral

  • Affects compensation arrangements and productivity-based payment

Medicare Coverage:

  • Covered when medically necessary

  • Local Coverage Determinations may apply - check your MAC

  • Typically requires documented diagnosis supporting need

  • May require prior authorization depending on payer

Commercial Payers:

  • Coverage varies by payer

  • Some require prior authorization

  • Verify coverage and medical necessity requirements

  • May have different coding requirements than Medicare

Documentation Red Flags to Avoid:

  • Billing for screening without signs/symptoms or risk factors

  • Inadequate interpretation report

  • Missing physician signature

  • Duplicate billing when included in other services

  • Billing bilateral with inappropriate modifiers

  • Using old billing methodology (per eye instead of per encounter)

Clinical Indications

Common diagnoses supporting medical necessity for 92132:

Glaucoma-Related:

  • H40.00x - Preglaucoma, unspecified

  • H40.10x - Primary open-angle glaucoma

  • H40.20x - Primary angle-closure glaucoma

  • H40.05x - Ocular hypertension

  • H40.06x - Primary angle closure suspect

Corneal Conditions:

  • H18.xx - Corneal disorders (ectasia, dystrophies, edema, scars)

  • H17.xx - Corneal scars and opacities

  • Q13.4 - Congenital corneal dystrophy

  • Z94.7 - Corneal transplant status

Anterior Segment Abnormalities:

  • Q13.0 - Coloboma of iris

  • Q13.1 - Absence of iris/Aniridia

  • H21.xx - Iris and ciliary body disorders

  • Q13.89 - Other congenital malformations of anterior segment

  • S05.xx - Injury of eye and orbit

Post-Surgical Monitoring:

  • Z98.89 - Other specified postprocedural states

  • Post-refractive surgery (LASIK, PRK, SMILE)

  • Post-keratoplasty

  • Post-glaucoma surgery

  • Post-cataract surgery with complications

Graph View

Recent Notes