About this policy
Jurisdiction: J15 MAC Part B. States: Kentucky, Ohio. Type: Active LCD
Coverage indications
Abstract: External ocular photography is a non-invasive procedure used to photo-document conditions of the external structures of the eye (e.g., eyelids, lashes, sclera, conjunctiva and cornea). External photography techniques may also be used to document conditions related to structures of the anterior segment of the eye. These would include the anterior chamber, iris, crystalline lens and filtration angle. External ocular photography is accomplished by using a slit-lamp-integrated camera, photography through a goniophotography lens or with a close-up stereo camera. Photographs may be prints, slides, videotapes or digitally stored. Indications: This procedure may be indicated when photo-documentation is required to track the progression or lack of progression of an eye condition, or to document the progression of a particular course of treatment. External ocular photography is covered when a special camera is used to obtain magnified photographs of lesions (e.g., the cornea, iris or lids) for the purpose of following the patient’s condition. Medical quality images may be digital, Polaroid Macro 3 SLF or equivalent. Limitations: While many conditions of the eye could be photographed, this procedure should not be used to simply document the existence of a condition in order to enhance the medical record. Photographs for the purpose of documentation for medical legal purposes or preauthorization (e.g., gross trauma, amount of ptosis or redundant lid tissue for blepharoplasty) are not separately reportable or reimbursable. Photography may be reported only once per session, even though multiple views may be taken. In addition to the photograph(s), an interpretation and report specific to the photograph(s) must be contained in the patient's medical record and be available to the contractor upon request. External ocular photography without accompanying patient identification and date permanently affixed to the photograph will be considered not to be reasonable or necessary and will be denied.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Showing the first 1,000 of 1,057 codes. The source has the full list.
| Code | Code system | Status in this policy |
|---|---|---|
| 92285 | CPT | Covered |
| A18.51 | ICD10CM | Covered |
| A18.52 | ICD10CM | Covered |
| A18.54 | ICD10CM | Covered |
| A18.59 | ICD10CM | Covered |
| A50.31 | ICD10CM | Covered |
| B00.50 | ICD10CM | Covered |
| B00.51 | ICD10CM | Covered |
| B00.52 | ICD10CM | Covered |
| B00.53 | ICD10CM | Covered |
| B00.59 | ICD10CM | Covered |
| B02.31 | ICD10CM |