CPT^® 92228, Under Ophthalmoscopy Procedures

The Current Procedural Terminology (CPT^®) code 92228 as maintained by American Medical Association, is a medical procedural code under the range - Ophthalmoscopy Procedures.

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Summary

The patient undergoes retinal imaging on one or both eyes in a location other than the reviewing provider’s location. The provider interprets the images remotely and prepares a report. The imaging helps with diagnosing and monitoring retinal disease.

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Forum

Have a question about CPT Code 92228 ? Start a discussion here

Modifier 59 or 25?

[QUOTE="amyjph, post: 515139, member: 172045"] The edit is being described as telling them to add a 59 to 92228, not a 25. 92228 is not an E&M, it's in the medicine section. If you run it through anot... [ Read More ]

Modifier 59 or 25?

[QUOTE="sls314, post: 515133, member: 523015"] Modifier 25 is only used on E/M procedures. It's the literal definition of the modifier - if they can't understand that, then I wouldn't trust anything ... [ Read More ]

Modifier 59 or 25?

[QUOTE="kamlambert, post: 515128, member: 484619"] Nextgen has added an edit (ILE ID 1) asking us to append a 59 modifier onto a 92228 billed w/ E&M. We do not feel that this is correct, and that a 25... [ Read More ]

Modifier 59 or 25?

Nextgen has added an edit (ILE ID 1) asking us to append a 59 modifier onto a 92228 billed w/ E&M. We do not feel that this is correct, and that a 25 modifier should be used on the E/M. I cannot find ... [ Read More ]

Can a Primary Care Provider bill 92250?

[QUOTE="cdiaz, post: 498060, member: 314499"] We are billing routine/diagnostic fundus photographs for diabetic patients but keep receiving denials from the insurance stating the provider does not mat... [ Read More ]

Can a Primary Care Provider bill 92250?

We are billing routine/diagnostic fundus photographs for diabetic patients but keep receiving denials from the insurance stating the provider does not match the billable code. I see there have been c... [ Read More ]

Retinopathy Eye Exam Screening?

Just found an article by Corcoran. It seems like you should bill the 92228 code since this includes an interpretation and report and is specific to telemedicine. In general, most carriers, including ... [ Read More ]

Retinopathy Eye Exam Screening?

I work for an FQHC and our patients are very low income and cannot afford to go to an ophthalmologist just for a screen. If we discover any abnormalities we refer them and try to get them set up with ... [ Read More ]

92250 done on Primary Care office

[QUOTE="Cheezum51, post: 408629, member: 329674"]You can't bill 92250 for what you're doing. You should bill 92228. I assume that your office is paying the ophthalmologist a set fee per patient so he ... [ Read More ]

92250 done on Primary Care office

You can't bill 92250 for what you're doing. You should bill 92228. I assume that your office is paying the ophthalmologist a set fee per patient so he won't have to file anything. Tom Cheezum, O.D., ... [ Read More ]

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