5 Key Takeaways

• 1

  Optometrists must document clinical findings and justify imaging for AMD using specific ICD-10 codes, like H35.31-H35.32.

• 2

  Billing for fundus photography (92250) and ocular coherence tomography (92134) together requires distinct medical necessity and correct modifiers.

• 3

  OCT and OCT-A are generally not billable together on the same day, and code 92229 for OCT-A has variable payor coverage.

• 4

  Documentation for ERG tests (92273, 92274) must include a clear test order, such as for evaluating macular function in AMD.

• 5

  Extended ophthalmoscopy (99202) submissions should include detailed fundus illustrations and a signed interpretation/report.