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What procedure Code Do I Use?

CPT 83861

  • The appropriate Current Procedural Terminology (CPT)(1) Code for the TearLab Osmolarity Test is 83861; "Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity."
  • When billing for two eyes, code 83861 twice, on two lines, using the RT and LT modifiers for 1-unit of service each, as follows:
    • 83861-RT
    • 83861-LT
  • If the carrier does not recognize the LT or RT modifier, or denies payment for the second eye tested, code 83861 only once, on one line, with no modifiers, but for 2-units of service
  • The above are general recommendations and guidance, which may vary from carrier to carrier. Always adhere to the coding policy as recommended by your carrier or billing specialist.

Medicare - CMS Part B Claims

For offices with CLIA Waiver Certificates, Medicare requires the use of a QW modifier when submitting claims. For CMS Medicare Part B, tests should be coded as follows:

  • 83861-QW-RT
  • 83861-QW-LT

If you receive denials, please contact the TearLab Reimbursement Support Center for more information or assistance.

(1) CPT is a copyright and registered trademark of the American Medical Association (AMA). Please consult with current CPT Manual for full descriptors and instructions regarding the use of these codes.

Disclaimer: The information provided on this website is current as of January 2021 and was obtained from third-party sources and is subject to change without notice as a result of changes in reimbursement laws, regulations, rules, policies, and payment amounts. All content on this website is informational only, general in nature, and does not cover all situations or all payers' rules and policies. This content is not intended to instruct hospitals and/or physicians on how to use or bill for healthcare procedures, including new technologies outside of Medicare national guidelines. A determination of medical necessity is a prerequisite that TearLab Corporation assumes will have been made prior to assigning codes or requesting payments.

Under Federal and State law, it is the individual provider's responsibility to determine appropriate coding, charges and claims for a particular service. Policies regarding appropriate coding and payment levels can vary greatly from payer to payer and change over time. TearLab Corporation recommends that providers contact their own regional payers to determine appropriate coding and charge or payment levels.

If you are a provider participating in a clinical trial, we recommend you contact your payers, including Medicare/Medicaid and private insurers, to verify correct coverage and reimbursement policies for investigational devices.

This website information represents no promise or guarantee by TearLab Corporation concerning coverage, coding, billing, and payment levels. TearLab Corporation specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information on this website.

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