Medical Billing Forum

Coding => Coding => Topic started by: Gayle33 on January 26, 2016, 09:02:51 AM

Title: Extended Ophthalmoscopy & Fundus Photo
Post by: Gayle33 on January 26, 2016, 09:02:51 AM
Is extended ophthalmoscopy 92225  & fundus photo 92250  covered procedures for E11.9 (diabetes w/out complications) and/or I10 (Hypertension) ?

Thank you 
Title: Re: Extended Ophthalmoscopy & Fundus Photo
Post by: Michele on January 26, 2016, 05:53:45 PM
What insurance carrier?  It may vary by plan.
Title: Re: Extended Ophthalmoscopy & Fundus Photo
Post by: Gayle33 on February 12, 2016, 09:15:17 AM
Medicare and Anthem B/C B/S


Thank you
Title: Re: Extended Ophthalmoscopy & Fundus Photo
Post by: Michele on February 12, 2016, 10:35:14 AM
I'm not sure about Anthem but with Medicare you will want to look for the LCD for both 92225 & 92250.  The LCD will list what ICD codes are billable for those procedure codes.  Go to your MAC website and go to the LCD section.  Do a search for '92225' and '92250' and you should be able to find them.  Our LCD for NY is:  http://www.mediquant.com/policy/L33567_20141001.pdf