I work for an Ophthalmology practice. Frequently, our doctors will bill an OCT (92134 or 92133) along with a Fundus Photo (92250), Visual Fields (92083), and maybe FA (92230 or 92235) or ICG (92240). I've been receiving denials from Medicare and other payers (in Pennsylvania) stating "bundled or not medically necessary". I know there are instances where multiple diagnostics are permitted when appropriate physician documentation is in place. For a line-up of the below codes, please advise correct modifiers and on which codes they are appropriate for Medicare and commercial insurance:
92083
92133 or 92134
92250
Also, if anybody knows the LCD that addresses this, please advise.
Thanks for your help.
92083
92133 or 92134
92250
Also, if anybody knows the LCD that addresses this, please advise.
Thanks for your help.