• Billing Multiple Retina Testing Services Same Day


    Although medical necessity may require multiple tests in a session, billing may not allow for all to be submitted. Always confirm if there is a bundling edit in place by the payer. 

    Let’s look at a new patient who requires the following tests same day: 
    92250 Fundus Photos
    92134 Retina OCT
    92242 FA and ICG combined
    92201 Extended ophthalmoscopy; with retinal drawing and scleral depression 

    For Medicare Part B and those payers who follow the Correct Coding Initiative (CCI) edits, there are bundles that exist limiting what can be submitted. CPT code 92250 is mutually exclusive with both extended ophthalmoscopy codes 92201 and 92202. It is also bundled with CPT codes 92134 and 92242. Therefore, the only tests to be submitted on the same date are:

    92242 FA and ICG combined
    92134 Retina OCT
    92201 Extended ophthalmoscopy; with retinal drawing and scleral depression

    For more information on CCI bundles, visit www.aao.org/coding.