Page 1 of 32
OPHTHALMIC CODING SPECIALIST EXAM NEWEST
2025 ACTUAL EXAM| COMPLETE 100 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+| OPHTHALMIC CODING
SPECIALIST EXAM REVIEW (MOST RECENT!!)
An established patient presents for an exam with the chief
complaint of a red irritated eyelid. The diagnosis is blepharitis.
The patient also has diabetes and recently received a
comprehensive eye exam. What should the diagnosis for today's
exam be? .....ANSWER.....Blepharitis only. The primary diagnosis
should relate to the chief complaint.
A 64 year old patient has cataract surgery. Now, at age 65, the
patient obtains post cataract glasses. Is this a covered benefit?
.....ANSWER.....Yes, HCPCS code V2020 Frames, purchases.
,Page 2 of 32
What is the correct code to use when removing a rust ring using
the slit lamp? .....ANSWER.....CPT code 65222 Removal of
foreign body, external eye; corneal, with slit lamp.
When coding Evaluation and Management services, what is
indicative of a moderate level of risk? .....ANSWER.....1. Minor
surgery with identified risk factors.
2. Elective major surgery with no identified risk factors.
3. Prescription drug management
Prior to inserting punctal plugs, what documentation should be
noted in the medical record? .....ANSWER.....1. Complaint
indicating dry eye symptoms such as burning, excessive tearing,
sensitive to light, etc.
2. Evidence that other methods of treatment have proven
unsuccessful.
3. Documentation of tear/glad deficiency or a Schirmer tear test.
,Page 3 of 32
The correct CPT code when inserting collagen punctal plugs is?
.....ANSWER.....CPT code 68761 Closure of the lacrimal punctum;
by plug, each.
True or False- All punctal procedures are payable per puncta.
.....ANSWER.....False. Only CPT code 68761. Closure of the
lacrimal punctum; by plug, each, is payable puncta. All other
lacrimal procedures are payable per eye.
True or False- Glare testing, brightness acuity testing, and
potential acuity measurement, are separately payable.
.....ANSWER.....False. These tests are included, but not countable
elements of an exam.
Besides the patient's health/vision insurance, what other payers
may be responsible for an ophthalmic exam?
.....ANSWER.....Workers Compensation, home owner insurance,
and automobile insurance.
, Page 4 of 32
True or False- Category 3 codes such as 0099T Implantation of
intrastromal corneal ring segments, are for new technology. As
such they are not assigned an allowable or a global period until
there is a payer specific coverage policy. .....ANSWER.....True
True or False- Medical records should be documented in black or
blue ink. .....ANSWER.....False. However since medical records
need to be copied on occasion, black and blue ink make the
duplication easier to read.
Major surgical global period includes: .....ANSWER.....The
management of complications following surgery, unless a return
to the operating room is required.
When documenting and coding E&M codes, the following
qualifies for what level of new patient exam?
1. A detailed history.
2. A detailed exam.
OPHTHALMIC CODING SPECIALIST EXAM NEWEST
2025 ACTUAL EXAM| COMPLETE 100 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+| OPHTHALMIC CODING
SPECIALIST EXAM REVIEW (MOST RECENT!!)
An established patient presents for an exam with the chief
complaint of a red irritated eyelid. The diagnosis is blepharitis.
The patient also has diabetes and recently received a
comprehensive eye exam. What should the diagnosis for today's
exam be? .....ANSWER.....Blepharitis only. The primary diagnosis
should relate to the chief complaint.
A 64 year old patient has cataract surgery. Now, at age 65, the
patient obtains post cataract glasses. Is this a covered benefit?
.....ANSWER.....Yes, HCPCS code V2020 Frames, purchases.
,Page 2 of 32
What is the correct code to use when removing a rust ring using
the slit lamp? .....ANSWER.....CPT code 65222 Removal of
foreign body, external eye; corneal, with slit lamp.
When coding Evaluation and Management services, what is
indicative of a moderate level of risk? .....ANSWER.....1. Minor
surgery with identified risk factors.
2. Elective major surgery with no identified risk factors.
3. Prescription drug management
Prior to inserting punctal plugs, what documentation should be
noted in the medical record? .....ANSWER.....1. Complaint
indicating dry eye symptoms such as burning, excessive tearing,
sensitive to light, etc.
2. Evidence that other methods of treatment have proven
unsuccessful.
3. Documentation of tear/glad deficiency or a Schirmer tear test.
,Page 3 of 32
The correct CPT code when inserting collagen punctal plugs is?
.....ANSWER.....CPT code 68761 Closure of the lacrimal punctum;
by plug, each.
True or False- All punctal procedures are payable per puncta.
.....ANSWER.....False. Only CPT code 68761. Closure of the
lacrimal punctum; by plug, each, is payable puncta. All other
lacrimal procedures are payable per eye.
True or False- Glare testing, brightness acuity testing, and
potential acuity measurement, are separately payable.
.....ANSWER.....False. These tests are included, but not countable
elements of an exam.
Besides the patient's health/vision insurance, what other payers
may be responsible for an ophthalmic exam?
.....ANSWER.....Workers Compensation, home owner insurance,
and automobile insurance.
, Page 4 of 32
True or False- Category 3 codes such as 0099T Implantation of
intrastromal corneal ring segments, are for new technology. As
such they are not assigned an allowable or a global period until
there is a payer specific coverage policy. .....ANSWER.....True
True or False- Medical records should be documented in black or
blue ink. .....ANSWER.....False. However since medical records
need to be copied on occasion, black and blue ink make the
duplication easier to read.
Major surgical global period includes: .....ANSWER.....The
management of complications following surgery, unless a return
to the operating room is required.
When documenting and coding E&M codes, the following
qualifies for what level of new patient exam?
1. A detailed history.
2. A detailed exam.
