Medicare Reimbursement for Fundus Photography

Topic: Fundus Photos

Sponsor: Nidek

Updated: 04/24/2018


This FAQ addresses the following:

  1. What is fundus photography?
  2. Is fundus photography performed with Nidek’s AFC-330 and DS-20 covered by Medicare and other payers?
  3. What CPT code is used to describe fundus photography?
  4. What documentation is required in the medical record to support a claim for fundus photography?
  5. How is fundus photography reimbursed?
  6. What is Medicare’s supervision requirement for fundus photography?
  7. Is fundus photography bundled with other tests or services?
  8. How often may we repeat this test?
  9. What is the frequency of fundus photography in the Medicare program?
  10. If coverage of fundus photography is unlikely or uncertain, how should we proceed?