CPT Category II Code Resources

CPT Category II Code Resources

The Importance of CPT® Category II Codes

Dilated eye exams are the clinical standard of care for a patient living with diabetes. Demonstrate the care you provide to health plans and providers by including diabetic eye exam Current Procedural Terminology (CPT) Category II on your VSP WellVision Exam® claims. 

News to Know

Coming Soon – Patient condition payments on VSP Advantage Plan WellVision Exam® claims with a date of service of January 1, 2025, or later.  

Review patient condition payments.

These codes provide information on exam results and services to support performance measures for programs, including Medicare’s Merit-based Incentive Payment System (MIPS), Healthcare Effectiveness Data and Information Set (HEDIS®), and Star Ratings. This industry-standard requirement reduces the need for office staff to pull patient records, promotes the valuable role of optometry in patient health care, and improves continuity of care and supports VSP® health plan clients meet quality measurement requirements.  

CPT Category II Resources

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Print this reference sheet to use when submitting  VSP WellVision exam claims for patients livings with diabetes.  It provides a list and description of the CPT Category II codes, as well as how to easily include them on claims using eClaim at eyefinity.com.

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Why Include CPT Category II Codes
 

See how including diabetic eye exam codes on your VSP WellVision exam claims supports your practice.

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Patient Condition Sticky Notes
 

These complimentary sticky notes allow you to easily notify your staff of patient conditions and applicable CPT Category II code to indicate on the patient’s chart notes and VSP WellVision exam claims. Order today through the Supply Request form on VSPOnline at eyefinity.com.

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VSPOnline
 

Find additional information about submitting patient conditions on your VSP claims.

Education Resources

Diabetes Education

Premier Edge Training and Education offers diabetes-focused on-demand education courses for both doctors and staff.

Diabetes Resources

Take advantage of additional diabetes-related resources located on the VSP Eye On Diabetes page.

CPT® is a registered trademark of the American Medical Association.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

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