Question: It seems to me that a diabetes diagnosis would make this procedure medically necessary as a baseline even if there is no retinopathy. Alabama Subscriber Answer: CPT defines code 92250 as "fundus photography with interpretation and report." In this particular service, there are several integral parts: • • • The technical aspects of special ophthalmological services which may or may not be performed by the doctor are "part of the service but should not be mistaken to constitute the service itself," according to CPT. Thus, a physician cannot charge for 92250 on the sole basis that a technician captured an image of a patient's retina and has placed it on the record. The case is similar to extended ophthalmoscopy (92226). If there is no diagnostic basis to support the finding, you cannot charge for it. Bottom line: Otherwise, it is considered a screening/preventative exam and not covered. In other words, you can't get paid to take a picture of a normal retina, even if the patient has a chronic disease.