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Extended Ophthalmoscopy & Fundus Photo

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Gayle33:
Is extended ophthalmoscopy 92225  & fundus photo 92250  covered procedures for E11.9 (diabetes w/out complications) and/or I10 (Hypertension) ?

Thank you 

Michele:
What insurance carrier?  It may vary by plan.

Gayle33:
Medicare and Anthem B/C B/S


Thank you

Michele:
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 

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