AUG 04, 2023
Appropriate Diagnosis for Fundus Photography
When billing fundus photos for a diabetic eye exam with no retinopathy, is ICD –10 code Z13.1 Encounter for screening for diabetes mellitus an appropriate diagnosis?
Answer:
This is not a payable diagnosis for fundus photography, CPT code 92250. Consult your local Medicare administrative contractor (MAC) at aao.org/lcds. In the absence of a published policy, you can consult other MAC policies or the Academy's Coding Coach.
If you missed the 2023 Fundamentals of Ophthalmic Coding Course, presented June 27 in collaboration with the Academy’s YO Committee, you can purchase the recording through Aug. 25.