Wiki Fundus Photography - interp only

[lcomeaux]

Scenerio:
Pt. seen in diabetes clinic. Clinic performs Fundus photography and sends the results to the ophthalmology clinic for interp.
Question:
Can the ophthalmologist charge for the interp only using 92250-26? Are there certain diagnosis codes that must be used for it to be covered?

 

[vpcats]

yes, but the performing facility needs to add a TC modifier to the "technical" portion (use of equipment etc).

Check your Medicare carrier to see if they have a LCD for this code and that will give you the covered dxs. Florida's does not cover 250.xx for 92250, if I remember correctly.