Ophthalmology and Optometry Coding Alert

Reader Question:

92240 Includes ICG Dye

Question: One of our physicians wants to know if we can bill for indocyanine-green dye. He said it is used for membrane peels and complex cataract surgery in an ambulatory setting. He said it is $125 a vial. Can we bill for this? If so, what is the CPT® code, and is there a specific diagnosis that would also go along with this?

Nebraska Subscriber

Answer: You should not separately report the indocyanine-green (ICG) dye itself. Using the ICG dye is considered part of the procedure. You’ll report CPT® code 92240 (Indocyanine-green angiography [includes multiframe imaging] with interpretation and report) for this procedure.

Similar situation: The guidelines for reporting ICG dye are the same as when you report a fluorescein angiography (92235, Fluorescein angiography [includes multiframe imaging] with interpretation and report): You don’t report the actual fluorescein dye used in the procedure.

Diagnosis solution: Contact your local Medicare carrier to determine the diagnosis codes that support the medical necessity for an ICG angiography. If your ophthalmologist has documented one of the appropriate diagnoses, you can report 92240 and expect to be paid.

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