I'm not aware of any major medical carrier that will pay for baseline fundus photos when no pathology is present.
Some medicare local carriers may be paying incorrectly but, most likely, if your records are audited and they see that the photos don't show any pathology, you will have to refund the money to Medicare plus possibly incur penalties.
I have read information from several sources on this and doing what you are doing should not be billed to MC and will eventually lead to major problems for you. Understand that 92250 is one of the codes that OIG is targeting for audits!
If you want to do baseline fundus photos, without pathology, the patient should be paying for those out of pocket and you should have them sign an NEMB form.
Tom Cheezum, O.D., CPC
PS - coding in a way that gets you paid for something that isn't covered isn't proper coding. Not saying you're doing this, but I've seen several practices that do that and most eventually get nailed for it.