Coding 92250 in a primary care setting

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Our office is internal medicine. We have had a lot of problems in getting patients to go to an ophthalmologist for care due to diabetes. One of the insurance companies we deal with suggested using a handheld retina device to take photos which in turn are sent to a ophthalmic provider for review. This is similar to telemedicine. However, since the code we would bill is 92250 per the company, I can see rejections due to this not being in our specialty. The company states their is a work around but I was wondering if anyone in primary care had experience with this they are willing to share. :)
 

Cheezum51

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Retinal exams

From personal experience, having utilized many different types of retinal imaging systems over the years, I can tell you that none of them truly replaces a dilated retinal exam. Many cameras don't have the resolution needed to pick up small retinal hemorrhages.

I know that it is hard to get your patients to have an annual dilated eye exam but that is the best way to assure good ocular health for diabetics.

The patients do not need to be referred to retinal specialists for these exams. They can be done by optometrists as well as general ophthalmologists who would then refer to a retinal specialist if necessary.

Tom Cheezum, O.D., CPC
 
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