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Ophthalmology and Optometry Coding Alert

Reader Questions:

Append TC for Baseline Retinal Photos

Published on Wed Sep 01, 2010

Question: An ophthalmologist in our practice would like to offer baseline photos, taken with his fundus camera, for patients who are interested. Can we charge a different fee compared to photos taken to monitor disease that include an interpretive report?Nevada Subscriber Answer: Start with medical necessity. Are the photos considered to be medically necessary for the care and treatment of the patients condition? If the answer is "no," the first step is to obtain an Advance Beneficiary Notice of Non-Coverage (ABN) and indicate that the photos are an option but not clinically necessary for the patient's clinical care. Include the cost of obtaining the photos. If the patient elects to have the photos and accepts financial responsibility, you can proceed with obtaining the photos. You should bill for just the technical component of the fundus photos. Report 92250-TC-GA (Fundus photography with interpretation and report; technical component). Append modifier TC to [...]
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