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Posted By Barbara on 12-01-2006, 13:27:00 in Ophthalmology
Good morning list

Do you know if the photos procedure 92250 (Retinal photos) can be billed
when it is associated with a diabetes diagnosis rather than retinal
diagnosis.

Thanks in advance - would appreciate immediate help with this quesiton
Comments (5)
Posted By Barbara on 12-01-2006, 14:03:00
Thanks very much
Posted By Mary on 12-01-2006, 14:03:00
YOu may want to check your local Medicare carrier policy. Palmetto GBA (Ohio) allows fundus photos for certain codes in the 250.xx series.


Mary Lou Martin, CMM, CPC
Skoda, Minotti & Co. Healthcare Services
Cleveland, Ohio
(440)449-6800
Posted By Tom on 12-01-2006, 13:59:00
For Texas Medicare, diabetes is an acceptible diagnosis for fundus
photos, with the following two provisions:

1) 250.52 (Type II) and 250.53 (Type I) are not acceptable since they
indicate uncontrolled diabetes. 250.50 and 250.51 will be accepted,
along with 362.0X for Diabetic Retinopathy where X = 1 thru 6. 362.07
for diabetic macular edema will also work.
2) If choosing 250.50 or 250.51, they cannot be your primary diagnosis
for conducting the exam, but will justify the photos.

Sorry for the blank posting previously. This is my first time posting.

Tom
Posted By Barbara on 12-01-2006, 13:57:00
There was no response on this one?
Posted By Tom on 12-01-2006, 13:38:00
Rhind, Barbara wrote:

>-- Ophthalmology Coding Discussion Group
>-- MsgId= 1330769--
>
>Good morning list
>
>Do you know if the photos procedure 92250 (Retinal photos) can be billed
>when it is associated with a diabetes diagnosis rather than retinal
>diagnosis.
>
>Thanks in advance - would appreciate immediate help with this quesiton
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