How To Use CPT Code 92227

CPT 92227 describes the imaging of the retina for the detection or monitoring of disease, with remote clinical staff review and report, either on one eye or both. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92227?

CPT 92227 can be used to describe the imaging of the retina for the purpose of detecting or monitoring disease. This code specifically applies when the reviewing clinical staff is located remotely from where the imaging takes place. The clinical staff analyzes the images and prepares a report based on their findings. This imaging procedure is valuable in diagnosing and monitoring retinal diseases.

2. Official Description

The official description of CPT code 92227 is: ‘Imaging of retina for detection or monitoring of disease; with remote clinical staff review and report, unilateral or bilateral.’ It is important to note that this code should not be reported in conjunction with codes 92133, 92134, 92228, 92229, or 92250.

3. Procedure

1. The patient undergoes retinal imaging on one or both eyes in a location separate from where the reviewing clinical staff is located.
2. The imaging system captures images of the retina using a wide-angle lens.
3. The images are then transmitted to the remote clinical staff for review and analysis.
4. The clinical staff analyzes the images and prepares a report based on their findings.

4. Qualifying circumstances

CPT 92227 is applicable when retinal imaging is performed on one or both eyes, and the reviewing clinical staff is located remotely. It is important to note that this code should not be reported in conjunction with codes 92133, 92134, 92228, 92229, or 92250.

5. When to use CPT code 92227

CPT code 92227 should be used when retinal imaging is performed on one or both eyes, and the reviewing clinical staff is located remotely. This code is specifically for the detection or monitoring of retinal diseases. It should not be used in conjunction with codes 92133, 92134, 92228, 92229, or 92250.

6. Documentation requirements

To support a claim for CPT 92227, the following documentation is required:

• Indication of the need for retinal imaging and the specific disease or condition being monitored
• Confirmation that the imaging was performed on one or both eyes
• Date of the imaging procedure
• Identification of the reviewing clinical staff who analyzed the images and prepared the report

7. Billing guidelines

When billing for CPT 92227, it is important to ensure that the imaging was performed on one or both eyes and that the reviewing clinical staff was located remotely. This code should not be reported in conjunction with codes 92133, 92134, 92228, 92229, or 92250. It is also important to note that there are separate codes for interpretation and report by a physician or other qualified healthcare professional (92228) and for point-of-care autonomous machine analysis and report (92229).

8. Historical information

CPT 92227 was added to the Current Procedural Terminology system on January 1, 2011. The code was later changed on January 1, 2021, to specify remote imaging for the detection of retinal disease with analysis and report under physician supervision, either on one eye or both.

9. Examples

1. A patient undergoes retinal imaging on both eyes, and the images are remotely reviewed and analyzed by clinical staff to detect any signs of diabetic retinopathy.
2. A retinal imaging procedure is performed on one eye, and the images are sent to remote clinical staff for monitoring the progression of age-related macular degeneration.
3. A patient with a history of retinal detachment undergoes retinal imaging on both eyes, and the images are reviewed remotely to assess the success of previous surgical interventions.
4. Retinal imaging is performed on one eye of a patient with glaucoma, and the images are analyzed remotely to monitor the progression of the disease and the effectiveness of treatment.
5. A patient with a suspected retinal tear undergoes retinal imaging on both eyes, and the images are reviewed remotely to confirm the diagnosis and determine the appropriate course of treatment.
6. Retinal imaging is performed on one eye of a patient with macular edema, and the images are sent to remote clinical staff for monitoring the response to anti-VEGF therapy.
7. A patient with a family history of retinal diseases undergoes retinal imaging on both eyes, and the images are remotely reviewed to screen for any signs of hereditary conditions.
8. Retinal imaging is performed on one eye of a patient with retinitis pigmentosa, and the images are analyzed remotely to assess the progression of the disease and provide recommendations for visual rehabilitation.
9. A patient with a history of retinal artery occlusion undergoes retinal imaging on both eyes, and the images are reviewed remotely to monitor the blood flow and detect any signs of recurrence.
10. Retinal imaging is performed on one eye of a patient with uveitis, and the images are sent to remote clinical staff for monitoring the inflammation and assessing the response to treatment.