Reader Questions:
Apply Initial EO Code to New Condition
Published on Thu Mar 04, 2010
Question: I'm confused about the extended ophthalmoscopy codes. Is 92225 for a new patient and 92226 for an established patient? Should I bill twice for both eyes? California Subscriber Answer: The extended ophthalmoscopy (EO) codes, 92225 (Ophthalmoscopy, extended, with retinal drawing [e.g., for retinal detachment, melanoma], with interpretation and report; initial) and 92226 (... subsequent), don't necessarily correspond to new and established patients. CPT does not intend for 92225 to be a one-time-only code,only to be used with new patients. Rather, report 92225 for the initial EO associated with new symptoms of a nonchronic condition. Example 1: The ophthalmologist sees a patient complaining of flashes and floaters. He performs an initial EO (92225), finding postvitreous detachment. He asks the patient to return in six weeks. At that visit, he performs an additional EO (92226). A few weeks after that, the patient returns, now complaining of blurred vision. Since this is [...]