| Allowed Reimbursamble Diagnoses Pertaining to 92225 |
| 115.02 Retinitis - Infection by Histoplasma Capsulatum [American histoplasmosis - Darling`s disease] |
| 130.2 Chorioretinitis Due To Toxoplasmosis |
| 190.5 Malignant Neoplasm - Retina |
| 190.6 Malignant Neoplasm - Choroid |
| 224.5 Benign Neoplasm - Retina [Retinal Nevus] |
| 224.6 Benign Neoplasm - Choroid [Choroidal Nevus] |
| 228.03 Hemangioma of Retina |
| 228.09 Hemangioma - Other Sites |
| 282.60 Sickle-cell Disease, Unspecified |
| 282.64 Sickle-cell/Hb-C Disease With Crisis |
| 282.68 Other Sickle-cell Disease Without Crisis |
| 360.01 Endophthalmitis - Acute |
| 360.21 Progressive High (degenerative) Myopia - Malignant myopia |
| 361.00 Retinal Detachment - Defect - Unspecified |
| 361.01 Retinal Detachment - Recent - Partial - One Defect |
| 361.02 Retinal Detachment - Recent - Partial - Multiple Defect |
| 361.03 Retinal Detachment - Recent - Partial - Giant Tear |
| 361.04 Retinal Detachment - Recent - Partial - Dialysis |
| 361.05 Retinal Detachment - Recent - Total or Sub-total |
| 361.06 Retinal Detachment - Old - Partial |
| 361.07 Retinal Detachment - Old - Total or Sub-total |
| 361.10 Retinoschisis - Unspecified |
| 361.11 Retinoschisis - Flat |
| 361.12 Retinoschisis - Bullous |
| 361.13 Retinal Cysts - Primary |
| 361.14 Retinal Cysts - Secondary |
| 361.19 Other Retinoschisis And Retinal Cysts |
| 361.2 Retinal Detachment Serous - without retinal defect |
| 361.30 Retinal Defect - Unspecified w/o Detachment |
| 361.31 Retinal Hole w/o Detachment |
| 361.32 Retinal Tear w/o Detachment |
| 361.33 Retina - Multiple Defects w/o Detachment |
| 361.81 Retinal Detachment - Tractional |
| 362.01 Background Diabetic Retinopathy |
| 362.02 Proliferative Diabetic Retinopathy |
| 362.03 Nonproliferative Diabetic Retinopathy |
| 362.04 Mild Nonproliferative Diabetic Retinopathy |
| 362.05 Moderate Nonproliferative Diabetic Retinopathy |
| 362.06 Severe Nonproliferative Diabetic Retinopathy |
| 362.07 Diabetic Macular Edema |
| 362.10 Background Retinopathy - Unspecified |
| 362.12 Retinopathy - Exudative - Coats` syndrome |
| 362.13 Changes In Vascular Appearance of Retina - Vascular sheathing of retina |
| 362.14 Retinal Microaneurysms - NOS |
| 362.15 Retinal Telangiectasia |
| 362.16 Retinal Neovascularization - NOS |
| 362.21 Retrolental Fibroplasia [Cicatricial retinopathy of prematurity] |
| 362.31 Central Retinal Artery Occlusion |
| 362.32 Arterial Branch Occlusion |
| 362.35 Central Retinal Vein Occlusion |
| 362.36 Venous Tributary (Branch) Occlusion of Retina - BVRO |
| 362.41 Retinopathy - Central Serous |
| 362.42 Serous Detachment of Retinal Pigment Epithelium [Exudative detachment] |
| 362.43 Hemorrhage Detachment of Retinal Pigment Epithelium |
| 362.52 Macular Degeneration - Exudative Senile (WET) [Kuhnt-Junius degeneration] |
| 362.53 Macular Degeneration - Cystoid |
| 362.54 Macular Cyst or Hole or Pseudo-hole of Retina |
| 362.56 Macular Puckering [Preretinal Fibrosis, Epiretinal membrane] |
| 362.63 Lattice Degeneration of Retina [Palisade degeneration of retina] |
| 362.74 Pigmentary Retinal Dystrophy [Retinitis Pigmentosa, Albipunctate] |
| 362.81 Retinal Hemorrhage |
| 362.83 Retinal Edema [Cotton Wool Spots, Macular, Peripheral, Localized] |
| 362.84 Retinal Ischemia |
| 363.00 Focal Chorioretinitis - Unspecified |
| 363.01 Focal Choroiditis and Chorioretinitis - Juxtapapillary |
| 363.03 Focal Choroiditis and Chorioretinitis of Other Posterior Pole |
| 363.04 Focal Choroiditis and Chorioretinitis - Peripheral |
| 363.05 Focal Retinitis and Retinochoroiditis - Juxtapapillary [Neuroretinitis] |
| 363.06 Focal Retinitis and Retinochoroiditis - Macular or Paramacular |
| 363.07 Focal Retinitis And Retinochoroiditis of other Posterior Pole |
| 363.08 Focal Retinitis And Retinochoroiditis - Peripheral |
| 363.10 Disseminated Chorioretinitis - Posterior |
| 363.11 Disseminated Chorioretinitis - Unspecified |
| 363.12 Disseminated Chorioretinitis - Peripheral |
| 363.13 Disseminated Chorioretinitis - Generalized |
| 363.14 Disseminated Retinitis and Retinochoroiditis - Metastatic |
| 363.15 Disseminated Retinitis and Retinochoroiditis - Pigment Epitheliopathy [Acute posterior multifocal placoid] |
| 363.20 Chorioretinitis - Unspecified [Choroiditis NOS, Retinitis NOS, Uveitis posterior NOS] |
| 363.21 Pars Planitis [Posterior cyclitis] |
| 363.22 Harada`s Disease |
| 363.30 Chorioretinal Scar - Unspecified |
| 363.70 Choroidal Detachment [Commotio Retinae, Choroidal Hemorrhage] |
| 363.71 Choroidal Detachment - Serous [Commotio Retinae, Choroidal Hemorrhage] |
| 363.72 Choroidal Detachment - Hemorrhagic [Commotio Retinae, Choroidal Hemorrhage] |
| 365.10 Open-angle Glaucoma Unspecified [Wide-angle Glaucoma NOS] |
| 365.11 Primary Open Angle Glaucoma [Chronic, Simple, Noncongestive, Nonobstructive] |
| 365.12 Low Tension Open-angle Glaucoma |
| 365.13 Pigmentary Open-angle Glaucoma |
| 365.14 Glaucoma of Childhood [Infantile, Juvenile Glaucoma] |
| 365.20 Primary Angle-closure Glaucoma Unspecified |
| 365.21 Intermittent Angle-closure Glaucoma [Interval, Sub-acute] |
| 365.22 Acute Angle-closure Glaucoma [Attack, Crisis] |
| 365.23 Chronic Angle-closure Glaucoma |
| 365.24 Residual Stage of Angle-closure Glaucoma |
| 365.31 Corticosteroid-induced Glaucoma Glaucomatous Stage |
| 365.32 Corticosteroid-induced Glaucoma Residual Stage |
| 365.42 Glaucoma Associated With Anomalies of Iris [Anomalies NEC, Atrophy, Essential] |
| 365.44 Glaucoma Associated With Systemic Syndromes |
| 365.62 Glaucoma Associated With Ocular Inflammations |
| 365.63 Glaucoma With Vascular Disorders of Eye |
| 365.65 Glaucoma Associated With Ocular Trauma |
| 368.15 Other Visual Distortions and Entoptic Phenomena [Refractive: diplopia; polyopia; Photopsia; Visual halos] |
| 379.21 Vitreous Degeneration [Vitreous cavitation, detachment, liquefaction] |
| 379.23 Vitreous Hemorrhage |
| 379.24 Other Vitreous Opacities [Vitreous Floaters, Vitreous Syneresis] |
| 379.26 Vitreous Prolapse |
| 379.29 Other Disorders of Vitreous |
| 379.34 Dislocation - Posterior Lens |
| 871.5 Penetration of Eyeball with Magnetic Foreign Body |
| 871.6 Penetration of Eyeball with Nonmagnetic Foreign Body |
| 996.53 Mechanical Complication Due To Ocular Lens Prosthesis |
| E931.4 Antimalarials/Drugs Acting On Other Blood Protozoa Causing Adverse Effects In Theraputic Use |
| V58.69 Long-Term (current) Use of
Other Medications
Need Help With other Codes or Just want a full time billing department to handle your optometric billing? Click here to contact opticXpress now!
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Tuesday, February 11, 2014
Optometric Billing-92225-Ophthalmoscopy Extended w retinal drawing - Initial-Acceptable DX Codes
We have done numerous posts on the 92225 proc code. My main reason for this is because it is highly abused among optometrists and optometric billers and billing staff alike. Therefore, in an effort to continue to provide more clarity on this subject I am publishing a list of acceptable Diagnosis Codes that can be reported to Medicare (and most other insurances) when billing for this procedure. I would like to point out that this list is based on Texas medicare Local Coverage Determinations (LCD's) but it is a good reference point for any state as variations in the rule are minute. If you have any questions about your state, feel free to contact Andrew Roy at 802-253-7201 and we will help you find the EXACT DX codes for your state.
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