Claim Filing Efficiency Coding Tip: Fundus Photography

We're keeping it simple today with just one important tip on fundus photography. Correct coding procedures are vital to learn early on in your filing journey. You don't want to learn the incorrect methods for fear of making the same mistakes and experiencing denied or rejected claims. So, we're bringing you researched tips and explaining best practices in our blogs.

Check out our latest coding tip to help you stay efficient in your claim filing processes:

Electronic claim submission can be tedious. 

Fundus Photography—CPT Code 92250: Fundus photography with interpretation and report

Eyecare practices should always note the performance of this test and any findings. During electronic claim filing, you only bill once even if the test is performed on both eyes. The billing might be split into a professional component (using modifier -26) and a technical component (using modifier –TC) if your practice is only performing the test and another provider will be doing the interpretation (or vice versa).

According to CCI version 18.1, 92250 cannot be filed with 99211 and is mutually exclusive with 92227.  This code is generally mutually exclusive with the codes 92133 or 92134 for scanning computerized ophthalmic diagnostic imaging (SCODI), posterior segment.

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Originally published in September 2012. Updated in April 2022.

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