Medicare Reimbursement for External Ocular Photography

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Topic: External Photos

Sponsor: Topcon Medical Systems

Updated: 07/01/2018

This FAQ addresses the following:

What is external ocular photography?
What diagnoses support a claim for external ocular photography?
What documentation is required in the medical record?
Does Medicare cover this test?
Must the physician be present while this test is being performed?
What CPT code is used to describe external ocular photography?
What does Medicare allow for external ocular photography?
Is external ocular photography bundled with other services?
What is the frequency of external ocular photography in the Medicare program?
How often may external ocular photography be repeated?
If Medicare or other payer does not cover external ocular photography, may we charge the patient?

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The reimbursement information is provided by Corcoran Consulting Group based on publicly available information from CMS, the AMA, and other sources. The reader is strongly encouraged to review federal and state laws, regulations, code sets, and official instructions promulgated by Medicare and other payers. This document is not an official source nor is it a complete guide on reimbursement. Although we believe this information is accurate at the time of publication, the reader is reminded that this information, including references and hyperlinks, changes over time, and may be incorrect at any time following publication.

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