Medicare Policy on Screening Fundus Photography
Topic: Screening
Sponsor: Nidek
Updated: 04/24/2018
This FAQ addresses the following:
- Does Medicare cover fundus photography performed with Nidek’s AFC-330 and DS-20?
- If the patient pays for a screening photo and pathology is found, may a claim be submitted to Medicare?
- If the patient does not pay for a screening photo and pathology is found, may a claim be submitted to Medicare?
- If we perform screening fundus photos and find pathology, when are additional fundus photos warranted?
- What are the attributes of a screening program?
- Why do some cameras have two modes: screening and medical?
- If a high resolution photo is taken on the same day as a low resolution screening photo, is a claim warranted?
- Does analysis of a photo justify an additional charge?
- Do Medicare’s regulations regarding fundus photography apply to both ophthalmologists and optometrists?
- What documentation is required in the medical record?
- Do other third party payers follow Medicare’s coverage and payment policies?
- How do we document the patient’s acceptance of financial responsibility for screening photos?