Awareness : Did You Know?

Did You Know? Weekly Educational Series #11

For the Week of April 3, 2017-Ophthalmology

Recently, two Local Coverage Determinations (LCDs) affecting Ophthalmology have been revised to include ICD-10-CM diagnosis code range T85.22XA-T85.22XS.  These are under the section “ICD-10 Codes that Support Medical Necessity” of LCD L34017 for Current Procedural Terminology (CPT®) codes 92225, 92226 and LCD L33670 for CPT® code 92250.

In addition, the LCD “Coding Guideline” attachment for ophthalmoscopy (LCD L34017) was updated to remove the statement indicating that CPT® codes 92225 and 92226 should not be billed with modifier 50.

  • fundus photography
  • ophthalmoscopy

Effective date:

The LCD revision related to CPT codes 92225, 92226, and 92250 is effective for claims processed on or after March 23, 2017, for services rendered on or after October 1, 2015.