JAN 16, 2024
Annual Extended Ophthalmoscopy With No Change
Are we able to bill ophthalmoscopy, extended; with drawing of optic nerve or macula (92202) annually if there is no change to the drawing?
Answer:
Who is the payer? Payer coverage can vary. For example, Palmetto's local coverage determination policy (LCD) states:
“Extended ophthalmoscopy of a fellow eye without signs or symptoms or new abnormalities on general ophthalmoscopic exam will be denied as not medically necessary. Repeated extended ophthalmoscopy at each visit without change in signs, symptoms or condition may be denied as not medically necessary.”
Routine indirect and/or indirect ophthalmoscopy is included in the evaluation and management (E/M) of Eye visit code and may not be reported separately. Find this and other coding clues in the Academy’s
Ophthalmic Coding Coach.