Home

99174 - 33 or 99177-33 CPT codes.

During the American Academy of Ophthalmology meeting in Atlanta November 2008, the RVU (relative value units) for new CPT code 99174 was announced; 0.69. Subsequently the code was downgraded (RVU 0.20) to reflect CMS-perceived less work for automated interpretation

After much work pioneered by Jack Bellows and others, this Current Procedural Terminology (CPT) code, a marked improvement from the investigational level 3 code 0065T.

Pediatricians will now be able to bill and should receive reimbursement for photoscreening young children. The USPSTF recognizes photoscreening age 3-5 with a B rating but "I" for age 1-2 years. As such, appending 99177 or 99174 with modifier -33 implies it is recognized coverage according to ACA (Obama Care) or modifier -59 when photoscreen used outside the schedule of a well-child visit.

In 2016, an alternative photoscreen code, 99177- was designated to cover photoscreening with automated interpretaion (Plusoptix, SPOT, 2WIN, GoCheckKids) while 99174 is reserved for photoscreening with remote / human interpretation (iScreen/GoCheckKids).

ABCD recognizes photoscreening to include a process of analyzing reflected electromagnetic radiation (light) from the refractive surfaces of both eyes with analysis and assignment of risk for preventable eye disease, specifically amblyopia. ABCD recommends that photoscreening be done between ages 12-24 months, again between age 3 and 4 years and again in Kindergarten.

The diagnostic code (ICD-10) for positive photoscreening can be H44.533 (icd-9 360.44). ICD-10 H53.04 is also for positive vision screen with medically indicated confirmatory exam.

ABCD History

Kids Eye Disorders

Amblyopia

Vision Screening

Issues

ABCD Clinics

References

Contact ABCD

Jack Bellows with Robert Arnold (above left).

Sean Donahue, MTI inventor Howard Freedman and Robert Arnold celebrate the completion of CPT code 99174 (below left)

AAP Bright Futures