Ophthalmology and Optometry Coding Alert

Don't overdo the diagnosis codes, experts warn. Fundus photography is a critical tool in your ophthalmologist's toolbox for diagnosing and tracking ocular disease. But there are many pitfalls between the performance of a 92250 service and a paid claim. Read on to discover how our experts advise coding and billing for fundus photography. 1. Show Medical Necessity by Not Overdoing Dx Codes Reporting a wrong -- or irrelevant -- diagnosis code for fundus photography (92250, Fundus photography with interpretation and report) is a common slip-up. Be sure you link only the appropriate diagnosis with the procedure. Example: The ophthalmologist performs a comprehensive ophthalmological service such as 92004 or 92014, and finds that the patient has cataracts (366.19, Other and combined forms of senile cataract) and macular degeneration (362.50, Macular degeneration [senile]of retina unspecified). He orders fundus photos for the macular degeneration and documents an interpretation and report. When you report 92250, you [...]