Medicare Reimbursement for External Photography

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Topic: External Photos

Sponsor: Nidek

Updated: 04/24/2018

This FAQ addresses the following:

What is external photography?
What CPT code should we use to describe this test?
What diagnoses support a claim for external photography?
Is the physician’s presence required while external photography is being performed?
What documentation is required in the medical record to support claims for external photography?
Does Medicare cover external photography performed with Nidek’s AFC-330?
What does Medicare allow for external photography?
What is the frequency of external photography in the Medicare program?
How often may this test be repeated?
Is external photography bundled with other services?
If coverage of external photography is unlikely or uncertain, how should we proceed?

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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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