How To Use CPT Code 92235

CPT 92235 describes the use of fluorescein angiography, a diagnostic procedure that involves the injection of a special dye into a patient’s vein to examine the blood vessels in one or both eyes. 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 92235?

CPT 92235 is a code used to describe the procedure known as fluorescein angiography. This diagnostic test involves the injection of a fluorescent dye into a patient’s vein, which causes the blood vessels in the eyes to become more visible. The provider then takes photographic images or videos of the blood vessels in the retina to examine their structure and detect any leaks or abnormalities. This procedure is commonly used to diagnose various eye diseases and tumors, as well as to prepare for certain forms of laser treatment.

2. Official Description

The official description of CPT code 92235 is: ‘Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral.’ It is important to note that if fluorescein angiography and indocyanine-green angiography are performed during the same patient encounter, CPT code 92242 should be used instead.

3. Procedure

1. After appropriate preparation and anesthesia, the provider injects a fluorescent dye into the patient’s vein.
2. The dye reaches the retina within 10 to 15 seconds and remains visible for approximately 10 seconds.
3. Using multiframe timing or a series of still or video images, the provider captures images of the blood vessels in the fundus (inner back part of the eye).
4. The provider then interprets the images, comparing them to any previous studies, and prepares a report summarizing the findings and their impact on clinical management or prognosis.

4. Qualifying circumstances

Fluorescein angiography is indicated for various eye diseases and tumors, as well as for certain laser treatments. The procedure is typically performed by ophthalmologists or other qualified eye care professionals. It is important to check with payers regarding their policies on coverage for specific indications, as some may consider the study investigational for certain conditions.

5. When to use CPT code 92235

CPT code 92235 should be used when performing fluorescein angiography with multiframe imaging and providing interpretation and a report. It is important to note that if both fluorescein angiography and indocyanine-green angiography are performed during the same patient encounter, CPT code 92242 should be used instead.

6. Documentation requirements

To support a claim for CPT code 92235, the provider must document the following information:

• Indication for the study and the specific eye condition being evaluated
• Details of the procedure, including the use of multiframe imaging
• Date of the procedure
• Start and end times of the procedure
• Summary of findings and comparison to any previous studies
• Impact of the test on clinical management or prognosis

7. Billing guidelines

When billing for CPT code 92235, ensure that the procedure includes multiframe imaging and interpretation with a report. It is important to follow payer-specific guidelines and policies regarding coverage for specific indications. Additionally, if both fluorescein angiography and indocyanine-green angiography are performed during the same patient encounter, CPT code 92242 should be used instead.

8. Historical information

CPT code 92235 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2017, with the description being updated to include multiframe imaging.

9. Examples

1. A patient with diabetic retinopathy undergoes fluorescein angiography to assess the extent of blood vessel leakage in the retina.
2. A provider performs fluorescein angiography on a patient with suspected macular degeneration to evaluate the presence of abnormal blood vessels.
3. Fluorescein angiography is performed on a patient with a retinal vein occlusion to determine the extent of the blockage and assess the need for further treatment.
4. A provider uses fluorescein angiography to evaluate a patient with a suspected choroidal melanoma, capturing images of the blood vessels in the choroid to aid in diagnosis.
5. Fluorescein angiography is performed on a patient with uveitis to assess the presence of inflammation and any associated vascular abnormalities.
6. A provider performs fluorescein angiography on a patient with a retinal detachment to evaluate the blood flow and identify any areas of leakage.
7. A patient with a history of laser treatment for diabetic retinopathy undergoes fluorescein angiography to monitor the effectiveness of the treatment and detect any recurrence of abnormal blood vessels.
8. Fluorescein angiography is performed on a patient with a suspected retinal artery occlusion to assess the extent of the blockage and determine the need for intervention.
9. A provider uses fluorescein angiography to evaluate a patient with a suspected optic nerve head drusen, capturing images of the blood vessels in the optic nerve to aid in diagnosis.
10. Fluorescein angiography is performed on a patient with a history of trauma to the eye to assess the presence of any vascular damage or leakage.