Advanced Search

Ophthalmology and Optometry Coding Alert

Diagnostic Tests:

92225-92226 Mythbuster: Read This Before Reporting Extended Ophthalmoscopy Bilaterally

Published on Thu May 05, 2011

Learn the truth behind these common EO misconceptions and earn $25 per procedure.It's a common procedure, performed thousands of times each year in ophthalmology offices -- but coding and billing for extended ophthalmoscopy is hardly straightforward. Misconceptions about EO can be costly: The procedure pays about $25 each time (based on unadjusted RVUs), so mistakes can add up. Read on to see if one of the following EO myths could be taking money out of your practice's pockets.Many ophthalmology coders aren't clear on when it's appropriate to report 92225(Ophthalmoscopy, extended, with retinal drawing [e.g., for retinal detachment, melanoma], with interpretation and report; initial) or 92226 (...subsequent).Myth #1: EO is inherently unilateral; carriers will pay twice the fee schedule amount for one eye if you report EO bilaterally.Reality: Carriers will not pay double for bilateral EO unless you can justify medical necessity for performing EO on both eyes. If you've diagnosed a [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Ophthalmology and Optometry Coding Alert

View All