Ophthalmology and Optometry Coding Alert

Question: Our ophthalmologist performs external ocular photography for a Medicare patient with a malignancy on her left eyeball. Is this a covered service?New York SubscriberAnswer: Based on the patient's diagnosis (190.0, Malignant neoplasm of eyeball, except conjunctiva, cornea, retina, and choroid), the photography should be covered -- if your ophthalmologist is taking the photos in an effort to "track or treat" the malignancy.Medicare will typically cover 92285 (External ocular photography with interpretation and report for documentation of medical progress) if the ophthalmologist is either: tracking the progression of the disease or checking the effectiveness of a particular course of treatment for the disease.If your ophthalmologist orders the photography for either of these purposes, you should report 92285 to Medicare. But if you are unsure about your local carrier's policy, contact your local Medicare carrier before filing the claim.If your ophthalmologist performed the photography to "track or treat" the disease, Medicare payers [...]