Ophthalmology and Optometry Coding Alert

Question: What are the different classifications of AI in CPT®, and which type does retinal imaging code 92229 fall under?

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Answer: CPT^® Appendix S categorizes artificial intelligence (AI) into three main hierarchies based on “the clinical procedure or service provided to the patient and the work performed by the machine on behalf of the physician or other qualified healthcare professional (QHP).”

These AI classifications are as follows:

Assistive: The machine works to detect only clinically relevant data. A physician or QHP must interpret the data and report the results.

Augmentative: The machine performs the work and analyzes or quantifies the data “in a clinically meaningful way.” This category also requires a physician or QHP to interpret and report the data.

Autonomous: The machine performs the work, then automatically analyzes the data, interprets the information, and produces clinically relevant conclusions independently without physician or QHP involvement.

Retinal imaging is a type of autonomous AI. Code 92229 (Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report …) describes the use of autonomous AI to image the retina and automatically analyze the images and provide a report.

Don’t miss: Because autonomous AI can operate almost without human interaction, CPT^® includes three different levels of autonomous AI, which differ based on the amount of physician involvement.