Optometry Coding & Billing Alert

Reader Question:

Don't Get Mad, Get Reimbursed

Question: One of our private carriers is denying 92250 when performed on the same day as fluorescein angiographies. I appealed, and the panel rejected it. Do you have any suggestions?
      
Arizona Subscriber
 
Answer: Appeal again! At one point, 92250 (Fundus photography with interpretation and report) was bundled into 92235 (Fluorescein angiography [includes multiframe imaging] with interpretation and report), but that bundle was deleted nearly eight years ago.

State specifically in your letter that the two procedures are not bundled, and be sure to send in a copy of the NCCI edits to prove that the carrier should separately reimburse those two services.

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