Corcoran, COE, is executive vice president and We would like to show you a description here but the site won’t allow us. They are all times when we’ve unbundled CPT code 92133 Scanning computerized OCT and FP: Why can’t I bill both? New guidance from CMS describes why and the few times when you can. This discussion is meant to assist the reader to better understand . Medical necessity issues are usually found in the LCD, For both codes, the allowable was per eye, but you couldn’t bill for an eye that didn’t have pathology. If this is the case in your area, you either need to bill the services and end up in the review and appeal process proving medical necessity or must select the intermediate-level eye code The remaining issues of billing and coding vary depending upon the test. Refer also to the Professional Services: Diagnosis Codes Extended ophthalmoscopy (92201, 92202), retinal screening imaging (92227, 92228, and 92229), and a technician exam (99211) are bundled with 92250. Ophthalmic Imaging CPT Codes and Payment Data - 2025 1All codes in this table are bilateral; bill once whether one or both eyes are tested. , for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral This FAQ Although medical necessity may require multiple tests in a session, billing may not allow for all to be submitted. It's important to use the correct modifier (s) to ensure CPT code 92202 is a medical billing code for extended ophthalmoscopy with drawing on the retina. Medical Necessity Aetna considers extended ophthalmoscopy with a detailed retinal drawing for evaluation of This service is primarily for the early detection of diabetic retinopathy.