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Modifier -50 on 92250

  1. #1
    Question Modifier -50 on 92250
    Medical Coding Books
    Would you use Modifier -50 on 92250 Fundus photography with interpretation and report?

    Code description:

    92250 - Ophthalmoscopy allows a complete view of the back of the eye. The physician or technician aligns the fundus camera, which is attached to an ophthalmoscope, along the patient's optical axis after the patient's pupil has been dilated. The 35 mm camera is, in effect, a large ophthalmoscope that allows viewing of the retina and a light flash system for producing color photographs of the retina. Both eyes are photographed. The results are interpreted by the physician.

    I would say no because the description states "Both eyes are photographed".

    What are your thoughts?

    Thanks so much for your input!

  2. #2
    Manhattan, NY
    Correct.... My coding software edits indicate that a 50 modifier is not allowed.

  3. #3
    Thanks so much for your input.

  4. #4
    What if you only get one eye? How do you bill it to Medicare?

  5. Default
    Use Modifier 52 for reduced services if you only image one eye. Without any modifier, 92250 is automatically considered a binocular procedure.

    Tom Cheezum, O.D., CPC, COPC

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