What is procedure code 92250?
CPT 92250 describes one or more images taken with the fundus camera, with or without filters. It is inappropriate to use another CPT codes such as 92499, Unlisted ophthalmologic service or procedure.
Does Aetna cover glaucoma testing?
Aetna considers the following medically necessary for evaluation of primary open-angle glaucoma: Computerized visual field examination. Gonioscopy. Measurement of optic nerve head and retinal nerve fiber layer.
What is Scanning computerized ophthalmic diagnostic imaging?
Scanning computerized ophthalmic diagnostic imaging (SCODI) allows for the early detection of glaucomatous damage to the nerve fiber layer or optic nerve and has demonstrated clinical utility in facilitating earlier diagnosis and treatment as well as monitoring for progression and response to treatment.
Does CPT code 92250 need a modifier?
CPT codes 92250 and 92228 describe services that are performed bilaterally. Modifier 50 is never appropriate with these codes.
Can CPT code 92250 and 92134 be billed together?
Coding Implications Fundus photography with interpretation and report—92250—and either 92133 or 92134 cannot be performed on the same date of service on the same patient.
What is the difference between a routine eye exam and a comprehensive eye exam?
Unlike a simple vision screening, which only assesses your vision, a comprehensive eye exam includes a battery of tests in order to do a complete evaluation of the health of your eyes and your vision.
What does CPT code 92133 mean?
Scanning computerized ophthalmic diagnostic imaging, posterior
92133. Scanning computerized ophthalmic diagnostic imaging, posterior segment, with. interpretation and report, unilateral or bilateral; optic nerve.
When should I use CPT codes 92250 and 92499?
Note: Use 92250 only to report photographs obtained with a camera on film or digital media. Note: Use 92499 to identify fundus images obtained with scanning laser equipment. It should be noted that there are National Correct Coding Initiative (NCCI) mutually exclusive edits for CPT codes 92135 and 92250.
What is the difference between Aetna’s clinical policy and medical necessity?
While Clinical Policy Bulletins (CPBs) define Aetna’s clinical policy, medical necessity determinations in connection with coverage decisions are made on a case by case basis. In the event that a member disagrees with a coverage determination, Aetna provides its members with the right to appeal the decision.
When does Aetna consider fundus photography medically necessary?
Aetna considers fundus photography medically necessary for any of the following indications: 1 Abnormal electro-oculogram (EOG). 2 Abnormal oculomotor studies. 3 Abnormal retinal function studies. 4 Abnormal visually evoked potential. 5 Age-related macular degeneration. 6 (more items)
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