Wiki Diabetic Eye Exam in PCP setting (Internal Medicine)

jhendrix08

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I work in a Primary Care office and my physician is thinking about purchasing the machine/software to perform diabetic eye exams. What would be the correct CPT code since it's being done in the primary care office setting? We're needing to check on reimbursement so I want to be sure I have the correct codes.

I would really appreciate any feedback if any of you have experience with this! Thanks in advance!!
 
Retinopathy screening

It is highly advisable to review the reimbursement policies for the specific test prior to investing. Here are examples of favorable policies for retinopathy telescreening: http://www.aetna.com/cpb/medical/data/500_599/0563.html and https://medicalpolicies.amerigroup.com/medicalpolicies/guidelines/gl_pw_a053783.htm. It is important to verify reimbursement policies of your local payers and also estimate the likely number of screenings (e.g., number of patients with diabetes ICD-10 codes reported) and reimbursement amounts vs. total costs of providing the services (equipment, staff, follow-up communication to patient).

Hope that helps,
Cindy
 
Thank you, Cindy!

Can you share with me how you go about finding these reimbursement policies online? I do have log-ins for most of our payers website but was assuming I would have to call to get the information for something this specific....I should have known that most everything can be found without making a phone call these days! :)

Thanks again for your time in offering advice.
 
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