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Key takeaways
- 92133 is optic nerve OCT, used for glaucoma, glaucoma suspects and optic nerve disease.
- It is billed once per date for one or both eyes, with no RT, LT or modifier 50.
- 92133 and 92134 are mutually exclusive on the same date, so only one is billed.
- Payers limit how often 92133 is paid, usually based on the glaucoma diagnosis and its stability.
What Is CPT Code 92133?
CPT 92133 is the code for optical coherence tomography (OCT) of the optic nerve, unilateral or bilateral, with interpretation and report. It measures the retinal nerve fiber layer and optic nerve head to diagnose and follow glaucoma.
92133 is one of 3 OCT codes in the ophthalmology CPT codes list. The table shows how they differ.
| Code | Area scanned | Common use |
|---|---|---|
| 92132 | Anterior segment | Angle closure, cornea |
| 92133 | Optic nerve | Glaucoma and optic neuropathy |
| 92134 | Retina | Macular degeneration, diabetic macular edema |
All 3 are billed once per date for one or both eyes.
Which Diagnoses Support 92133?
92133 is supported by glaucoma, glaucoma suspect, ocular hypertension and optic nerve disease diagnoses that the payer's coverage policy lists. The diagnosis must be the reason for the scan.
| Condition | ICD-10-CM code family |
|---|---|
| Primary open-angle glaucoma | H40.11- with stage |
| Glaucoma suspect, open angle | H40.01-, H40.02- |
| Ocular hypertension | H40.05- |
| Chronic angle-closure glaucoma | H40.22- with stage |
| Optic atrophy and other optic nerve disorders | H47.- |
Glaucoma codes need a complete stage and eye, as set out in the ophthalmology ICD-10 codes list.
Why Can 92133 and 92134 Not Be Billed Together?
NCCI edits treat 92133 and 92134 as mutually exclusive on the same date, so only one of them is paid. A patient with glaucoma and macular disease needs a choice at each visit.
Bill the code that matches the main reason for the scan that day. When both areas need to be followed, scan the optic nerve at one visit and the retina at the next, with the reason written each time. Retina OCT is covered in its own guide, CPT 92134.
Can 92133 be billed with fundus photos or visual fields?
92133 can be billed with a visual field, such as 92083, on the same date, because the tests measure structure and function. Some payers limit 92133 with fundus photography (92250) on the same date, so check the payer policy and document why each test was needed.
How Often Is 92133 Paid?
Payers limit how often 92133 is paid, based on the diagnosis and whether the disease is stable. Medicare limits are set in each contractor's local coverage determination.
A common pattern is about once a year for a stable glaucoma suspect and more often for glaucoma that is progressing or poorly controlled. A scan repeated sooner needs a reason in the record, such as a pressure rise, a field change or a new treatment.
- Check the payer's limit before scheduling a repeat scan
- Write why a scan was repeated early
- Track the last scan date for each patient
What Must the 92133 Report Include?
The 92133 report must give the findings for each eye scanned, compare them with earlier scans and state how they affect the plan. A printout without a written interpretation does not support payment.
- Reason. Why the scan was ordered.
- Findings. Nerve fiber layer and optic nerve results for each eye.
- Comparison. Stable or changed from earlier scans.
- Plan. How the result changes or supports treatment.
The report should be signed by the provider who read the scan.
What Does a 92133 Claim Look Like?
A 92133 claim bills the code once with 1 unit and a glaucoma diagnosis with stage and eye. The example shows a glaucoma follow-up with a scan and a visual field.
| Claim line | Units | Diagnosis |
|---|---|---|
| 92012 | 1 | H40.1132, primary open-angle glaucoma, both eyes, moderate stage |
| 92133 | 1 | H40.1132 |
| 92083 | 1 | H40.1132 |
The 2026 Medicare national office amount for 92133 is roughly $31 before geographic adjustment, so the frequency rules matter more than the fee on any single claim.
Why Do 92133 Claims Deny?
92133 claims deny most often because 92134 was billed the same day, the scan was repeated too soon or the diagnosis is not covered. These checks catch most of them.
- 92133 and 92134 billed on the same date
- A repeat scan inside the payer's frequency limit with no reason given
- A glaucoma code without its stage or eye
- RT, LT or modifier 50 on the line
- No signed interpretation and report
Our glaucoma billing services team tracks scan dates and frequency limits for every glaucoma patient.