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Thread: OTC and Photos

  1. #1

    Default OTC and Photos

    AAPC: Back to School
    Can and OCT exam and photos be performed on the same day and both be reimbursed?

    Also can Visual Field exams and an OCT both be done on the same day and both be reimbursed?

    Help Please!!!
    Last edited by khoyt; 05-25-2010 at 10:08 AM.

  2. #2


    Check your MAC/carrier's website. There are LCDs for these codes.
    Check especially the OCT code 92135. Usually OCTs and fundus photos are bundled, at least for Medicare. Other payers may not have a bundle but they could have utilization parameters and diagnosis limits.

    If you have a bundling payer (Medicare), you can unbundle with mod 59 but be VERY CAREFUL. Make sure you have good documentation for medical necessity.

    Most payers are getting very strict about how and when they pay for OCT.

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