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January 2013

GM covers optometrist services billed with medical diagnosis

General Motors will allow payment to an optometrist for services within his or her scope of practice when those services are billed with a medical diagnosis, beginning Jan. 1, 2013. This benefit change is applicable to all General Motors membership.

Effective Jan. 1, 2010, one routine eye exam per calendar year is covered under the medical benefit when these conditions are met:

  • Reported with specified diagnosis codes
  • Performed by either an optometrist or ophthalmologist in location 3 or 8
  • Performed for General Motors salaried active members and General Motors Subsystems Manufacturing HSA active members

Procedure codes *92002, *92004, *92012, *92014, *92015, S0620 and S0621 are covered for the following diagnoses: Categories 22 and 23, V72.0, V80.0, V80.2, 367.0, 367.1, 367.20, 367.21, 367.22, 367.31, 367.32, 367.4, 367.51, 367.52, 367.53, 367.81, 367.89, 367.9 and 368.03.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2012 American Medical Association. All rights reserved.
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