AAPC - Back to school
Results 1 to 6 of 6

Thread: Fundus Autofluorescence Photography

  1. #1

    Question Fundus Autofluorescence Photography

    AAPC: Back to School
    Can anyone tell me what CPT code(s) to use for Fundus Autofluroesence Photography??
    Is anyone billing for it??

    Thank you,

  2. #2


    Hey Sheila,
    You want to use 92250 for Fundus Autofluorescence photography. Check with your Medicare LCD to see what documentation and Dx meets medical necessity. Most Medicare MACs will allow a couple or more photos a year so you can track the progression of a disease if it “effects the management”. A lot of clinicians have been using Autofluorescence to track conditions like AMD.

    Also make sure that there is a separate interpretation and report for the photos.

    Hope this helps.

    John Uecke CPC, CPMA, CHA, COBS, CMOM, OCS

  3. #3


    We have an endocrinologist that would like to perform and bill for a fundus exam and he would send the report to be read by an outside physician. Can a non-optho physician bill and get reimbursed for a fundus exam?

  4. #4

    Default Oct and Fundus


    I have a couple questions regarding fundus photography CPT 92250 reimbursement. The doctors in our practice are thinking about buying a new fundus camera & spectral domain OCT.

    1) We have been told from several manufacturing OCT reps that you can use the SLO (scanning laser ophthalmoscope) scan on the OCT for fundus photography 92250 reimbursements. They claim that the SLO fundus image is considered to be equal to a standard digital fundus camera? So, can one OCT be used for both 92133, 92134 & used for fundus photography 92250? Is this true?

    2) Some of the new fundus cameras on the market do not use the traditional digital camera. Does a new style SLO generated fundus scan qualify for 92250 reimbursements?

    Thank you,

  5. #5
    Join Date
    Apr 2007


    To Eye:
    An OCT is an OCT and Fundus photos are fundus photos. One uses optical coherence and the other is digital photography. OCT optic nerve used for glaucoma to check for nerve fiber damage is 92133. OCT retina used for macular edema and retinal detachment is 92134. Fundus photos, different instruments, with/without autofluorescence is used to check cup/rim in glaucoma and provides a detailed view of vascular components of choroid as in CRVO/BRVO,etc is 92250. Per current NCCI edits you cannot bill 92133/92134 with 92250 unless there is medical necessity-different illness in other eye. Years back a hefty fine was imposed for billing these two tests together in the same session. While it is true OCT data can be used to give similar information as fundus photos they are not the same test. All of these are inherently bilateral with a -TC and -26 component.

  6. #6
    Join Date
    Apr 2007


    To Pride,
    For reasons too involved and explanations too long to discuss in this post tell your endo doc to refer his patient to an ophthalmologist. It will save him/her a big headache.

Similar Threads

  1. CPT 99250 Fundus photography
    By pygreen in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 12-02-2015, 05:58 AM
  2. Fundus Photography - interp only
    By lcomeaux in forum Ophthalmology/Optometry
    Replies: 1
    Last Post: 07-26-2014, 05:31 PM
  3. 92250 Fundus photography
    By primarymedbilling@yahoo.com in forum Ophthalmology/Optometry
    Replies: 4
    Last Post: 06-25-2014, 01:17 PM
  4. Photography Codes
    By idjimenez in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-27-2013, 12:25 PM
  5. Photography Coding and Billing
    By swtmisty in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 12-09-2009, 04:31 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.