• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Special Ophthalmologic Services

Create Wiki
D

DD531816

Contributor
Messages
10
Best answers
0
Good morning,

I am new to ophthalmology and have questions regarding CPT 92225 and 92226. It seems unclear as to whether or not these services can be billed alone and/or with an eye exam. What documentation needs to be in place for these codes. Any guidance or directions is greatly appreciated. Thanks

Doreen
 
A drawing of the retinas (each eye) and where any defects (if found) must be done, either in the body of the exam or as a sep. document w/a note in exam to reference the separate signed document.
On another note, our experience has been that some commercial payers will pay for this service as well as the eye exam, and others will not(including gov't), considering the extended ophthalmoscopy to be bundled w/the exam. Definitely submit your eye exam/ov code w/a 25 mod when billing both codes.
 
Thanks for the help. I am wondering if the 92225 and 92226 can be billed alone as long as the proper documentation, ie drawings and report, are included and signed by the physician? The explanation in the CPT book is confusing.
 
You must log in or register to reply here.
Top