Optometry Coding & Billing Alert
External Ocular Photography
Question: Our optometrist is interested in code 92285. What are the guidelines for reporting that code? What qualifications would a patient need? What diagnoses are covered?
Michigan Subscriber
Answer: The main rule for reporting 92285 (External ocular photography with interpretation and report for documentation of medical progress) is that you must be taking the photos to track the progression (or lack of progression) of a disease, or to document the progression of a particular course of treatment.
-[T]his procedure should not be used to simply document the existence of a condition in order to enhance the medical record,- says the local coverage determination (LCD) from Part B carrier HGSA, using language found in several other carriers- policies.
When can you report 92285? Among the ICD-9 codes that many carriers list as supporting medical necessity for external ocular photography are 190.0-190.9 (Malignant neoplasm of eye), 364.51-364.59 (Degenerations of iris and ciliary body), and 370.60-370.64 (Corneal neovascularization). Check with your local carrier for additional guidelines.
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