How To Use CPT Code 92285

CPT 92285 refers to external ocular photography with interpretation and report for documentation of medical progress. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 92285.

1. What is CPT 92285?

CPT 92285 is a medical procedure code that describes external ocular photography with interpretation and report for documentation of medical progress. This procedure is used to capture magnified images of various parts of the eye for the purpose of tracking or treating abnormalities. The code is applicable when the photography is medically necessary and is supported by appropriate diagnosis codes.

2. 92285 CPT code description

The official description of CPT code 92285 is: “External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)”.

3. Procedure

The 92285 procedure involves the following steps:

1. Preparation of the patient and positioning for photography.
2. Selection of the appropriate camera and settings for capturing magnified images of the eye.
3. Photographing the relevant parts of the eye, such as the eyelids, lashes, cornea, conjunctiva, sclera, iris, lens, and the angle between the cornea and iris.
4. Interpretation of the photographs by a qualified professional.
5. Preparation of a detailed report documenting the findings, including the date of photography and review, the eye(s) photographed, and any abnormalities identified.

4. Qualifying circumstances

Patients are eligible to receive CPT code 92285 services if they have a medical condition or abnormality that requires documentation through external ocular photography. The procedure must be medically necessary and supported by appropriate diagnosis codes. Photos taken merely to enhance the patient’s chart or for medicolegal purposes are not allowed.

5. When to use CPT code 92285

It is appropriate to bill the 92285 CPT code when external ocular photography is required for the documentation of medical progress in tracking or treating an abnormality. The procedure should not be used to simply document the existence of a condition to enhance the medical record. An interpretation and report specific to the external ocular photographs must be kept in the patient’s record and be available to the carrier upon request.

6. Documentation requirements

To support a claim for CPT 92285, the following information must be documented:

• Medical necessity for the external ocular photography, supported by appropriate diagnosis codes.
• Details of the eye(s) photographed, the date the photographs were taken and reviewed, and any abnormalities identified.
• A separate interpretation and report specific to the external ocular photographs, which must be kept in the patient’s record and be available to the carrier upon request.

7. Billing guidelines

When billing for CPT code 92285, it is important to ensure that the procedure is medically necessary and supported by appropriate diagnosis codes. Additionally, a separate interpretation and report specific to the external ocular photographs must be kept in the patient’s record and be available to the carrier upon request. Polaroid photographs for medicolegal purposes or preauthorization are not separately reimbursable, as they are not considered medically necessary.

8. Historical information

CPT 92285 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 92285

Five similar codes to CPT 92285 and how they differentiate are:

1. CPT 0330T: This code is used for tear film imaging, which is not covered by CPT 92285.
2. CPT 0507T: This code is used for meibomian gland imaging, which is not covered by CPT 92285.
3. CPT 92250: This code is used for fundus photography, which focuses on the retina and optic nerve, rather than the external parts of the eye.
4. CPT 92065: This code is used for orthoptic and pleoptic training, which involves eye exercises and is not related to photography.
5. CPT 92060: This code is used for sensorimotor examination, which assesses eye movement and coordination, and does not involve photography.

10. Examples

Here are 10 detailed examples of CPT code 92285 procedures:

1. A patient with a corneal ulcer requires external ocular photography to monitor the healing process.
2. A patient with a history of recurrent iritis needs documentation of the current state of the iris to track any changes over time.
3. A patient with a pterygium requires photography to assess the size and progression of the growth.
4. A patient with a suspected foreign body in the eye needs external ocular photography to confirm its presence and location.
5. A patient with a corneal dystrophy requires photography to document the progression of the condition.
6. A patient with a history of ocular melanoma needs external ocular photography to monitor for any signs of recurrence.
7. A patient with a conjunctival tumor requires photography to assess the size and progression of the growth.
8. A patient with a history of episcleritis needs documentation of the current state of the sclera to track any changes over time.
9. A patient with a suspected corneal abrasion requires external ocular photography to confirm the presence and extent of the injury.
10. A patient with a history of uveitis needs external ocular photography to monitor for any signs of recurrence or complications.