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Ophthalmology and Optometry Coding Alert

Show Medical Necessity for Fundus Photography

Published on Tue Aug 03, 2004

Many carriers will accept the ICD-9 codes below as diagnoses that demonstrate the medical necessity for fundus photography. Check your carrier for any LMRPs or LCDs.

  • 115.92 -- Histoplasmosis, unspecified, retinitis
  • 130.2 -- Chorioretinitis due to toxoplasmosis
  • 190.5 -- Malignant neoplasm of retina
  • 190.6 -- Malignant neoplasm of choroid
  • 224.5 -- Benign neoplasm of retina
  • 224.6 -- Benign neoplasm of choroid
  • 238.8 -- Neoplasm of uncertain behavior of other specified sites
  • 238.9 -- Neoplasm of uncertain behavior; site unspecified
  • 250.00 -- Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled
  • 250.01 -- Diabetes mellitus without mention of complication, type I, not stated as uncontrolled
  • 270.2 -- Other disturbances of aromatic amino-acid metabolism
  • 360.20-360.24 -- Degenerative disorders of globe
  • 360.50 -- Foreign body, magnetic, intraocular, unspecified
  • 360.54-360.59 -- Foreign body, magnetic
  • 360.64-360.69 -- Foreign body, nonmagnetic
  • 361.xx -- Retinal detachments and defects
  • 362.xx -- Other retinal disorders
  • 363.xx -- Chorioretinal inflammation, scars and other disorders of choroid
  • 365.xx -- Glaucoma
  • 377.00-377.49 -- Disorders of optic nerve and visual pathways
  • 379.00 -- Scleritis, unspecified
  • 379.07 -- Posterior scleritis
  • 379.09 -- Other scleritis
  • 379.11 -- Scleral ectasia
  • V58.65 -- Long-term (current) use of steroids
  • V58.69 -- Long-term (current) use of other medications
  • V67.51 -- Follow-up examination following completed treatment with high-risk medications, not elsewhere classified

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