Ophthalmology and Optometry Coding Alert

Question: When billing Medicare for a fundus photography, we bill for each eye. We put left and right on each charge, but Medicare only pays for one. How can we bill this so they will pay for both eyes, and not just one?

Anonymous North Carolina Subscriber

Answer: Fundus photography (92250) is a bilateral code in the Medicare program. When the ophthalmologist or technician views the retina with the camera after dilation, both eyes are photographed. There is no way to bill for both eyes. The code applies to one or both eyes. An interpretation and report must be provided as well to receive payment.