Which code is used for a comprehensive eye exam for an existing patient?

• A. New patient comprehensive exam
• B. Pediatric exam
• C. Comprehensive eye exam for an existing patient
• D. Contact lens exam

Answer: (C)

In ophthalmic coding, you pick codes based on both the exam type and the patient’s status with the provider. For a patient who already has an established relationship with the clinician and is receiving a full, comprehensive eye exam, you use the code designated for a comprehensive exam for an established patient. This matches the scenario of a thorough evaluation of vision and eye health performed on someone the doctor has previously seen.

The other options fit different situations: a new-patient comprehensive exam is used when the patient is new to the practice; a pediatric exam targets children; a contact lens exam is a separate service specifically for contact lens fitting and related checks, not a general comprehensive eye exam for an established patient.