CPT Code: 92225 Region: 02
States covered: Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont, Wisconsin
Title: Extended Ophthalmoscopy for the Initial Visit
Category
Special Ophthalmological Services
Description
Extended Ophthalmoscopy with retinal drawings (eg, for retinal detachment, melanoma) with interpretation and report for the initial visit"
State | City/County | Participating Provider Fee | |
---|---|---|---|
Connecticut | All counties | 29.23 | |
Illinois | East St. Louis / Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. Clair and Washington | 26.71 | |
Illinois | Suburban Chicago / Dupage, Kane, Lake and Will | 28.37 | |
Illinois | Chicago / Cook | 28.27 | |
Illinois | All other counties | 26.22 | |
Maine | Southern Maine / Cumberland and York | 27.24 | |
Maine | All other counties | 26.09 | |
Massachusetts | Metropolitan Boston / Middlesex, Norfolk and Suffolk | 29.83 | |
Massachusetts | All other counties | 28.37 | |
Minnesota | All counties | 27.25 | |
New Hampshire | All counties | 27.95 | |
New York | Manhattan / New York | 30.54 | |
New York | New York City suburbs, Long Island / Bronx, Kings, Nassau, Richmond, Rockland, Suffolk and Westchester | 31.05 | |
New York | Poughkpsie, North New York City suburbs / Columbia, Delaware, Dutchess, Greene, Orange, Putnam, Sullivan and Ulster | 28.55 | |
New York | Queens | 31.05 | |
New York | All other counties | 26.47 | |
Rhode Island | All counties | 28.26 | |
Vermont | All counties | 27.28 | |
Wisconsin | All counties | 26.52 |
Extended ophthalmoscopy is the detailed examination of the retina and always includes a true drawing of the retina, with interpretation and report. It is most frequently performed utilizing an indirect lens, although it may be performed using contact lens biomicroscopy. It may require scleral depression and is usually performed with the pupil dilated. It is performed by the physician when a more detailed examination (including that of the periphery) is needed, following routine ophthalmoscopy. The examination must be used in the medical decision making for the patient.
Extended ophthalmoscopy is indicated when the level of examination requires a complete view of the posterior segment of the eye and documentation is greater than that required for general ophthalmoscopy.
An extended ophthalmoscopy may be considered medically reasonable and necessary for the following conditions:
- Malignant neoplasm of the retina or choroid
- Retained (old) intraocular foreign body, either magnetic or nonmagnetic. Signs and symptoms may include a statement by the patient that something has hit his/her eye (foreign body sensation), normal or blurred vision, pain or no discomfort, and tearing.
- Retinal hemorrhage, edema, ischemia, exudates and deposits, hereditary retinal dystrophies or peripheral retinal degeneration
- Retinal detachment with or without retinal defect. The patient may complain of light flashes, dark floating specks, and blurred vision that becomes progressively worse. This may be described by the patient as “a curtain came down over my eyes.”
- Symptoms suggestive of retinal defect (ex: flashes and/or floaters)
- Retinal defects without retinal detachment
- Diabetic retinopathy (i.e., background retinopathy or proliferative retinopathy), retinal vascular occlusion, or separation of the retinal layers. This may be evidenced by microaneurysms, cotton wool spots, exudates, hemorrhages, or fibrous proliferation.
- Experienced sudden visual loss or transient visual loss
- Chorioretinitis, chorioretinal scars or choroidal degeneration, dystrophies, hemorrhage and rupture, or detachment
- Sustained a penetrating wound to the orbit resulting in the retention of a foreign body in the eye
- Sustained a blunt injury to the eye or pariorbita
- Disorders of the vitreous body (i.e., vitreous hemorrhage or posterior vitreous detachment). Spots before the eyes (floaters) and flashing lights (photopsia) can be signs/symptoms of these disorders.
- Posterior scleritis. Signs and symptoms may include severe pain and inflammation, proptosis, limited ocular movements, and a loss of a portion of the visual field.
- Vogt-Koyanagi syndrome. A condition characterized by bilateral uveitis, dysacousia, meningeal irritation, whitening of patches of hair (poliosis), vitiligo, and retinal detachment. The disease can be initiated by a severe headache, deep orbital pain, vertigo, and nausea.
- Degenerative disorders of the globe
- Retinoschisis and retinal cysts. Patients may complain of light flashes and floaters.
- Signs and symptoms of endophthalmitis, which may include severe pain, redness, photophobia, and profound loss of vision
- Glaucoma or is a glaucoma suspect. This may be evidenced by increased intraocular pressure or progressive cupping of the optic nerve.
- Systemic disorders which may be associated with retinal pathology
- High axial length myopia
- Retinal edema
- Metamorphopsia
- High-risk medication for retinopathy or optic neuropathy
- Choroidal nevus being evaluated for malignant transformation
- Macular degeneration
Limitations:
- Extended ophthalmoscopy of a fellow eye without signs or symptoms or new abnormalities on general ophthalmoscopic exam will be denied as not medically necessary. Repeated extended ophthalmoscopy at each visit without change in signs, symptoms or condition may be denied as not medically necessary.
- General ophthalmoscopy and biomicroscopy are part of an ophthalmologic examination (92002-92004) and are not separately payable, but these should still be documented in the patient’s medical record
- If indirect ophthalmoscopy is done without a drawing or does not meet the standards indicated in the attached Appendix A, the service is not separately payable and will be considered part of a general ophthalmologic exam (92002-92014) or E&M service
- Extended ophthalmoscopy (codes 92225, 92226) performed during the global surgery period of an ophthalmologic surgery procedure, by the same provider performing the surgery, will not be separately payable unless unrelated to the condition for which the surgery was performed
- If the medical record does not include the interpretation and report, the extended ophthalmoscopy will be denied as not medically necessary
- Extended ophthalmoscopy will be denied as not medically necessary when it is done in lieu of routine ophthalmoscopy unless the indication for this more extensive examination is documented in the medical record
- When other ophthalmological tests (e.g., fundus photography, fluorescein angiography, ultrasound, optical coherence tomography, etc.) have been performed, extended ophthalmoscopy will be denied as not medically necessary unless there was a reasonable medical expectation that the multiple imaging services might provide additive (non-duplicative) information
ICD-10 Diagnosis Codes
ICD-10 Codes | Description |
---|---|
A18.53 | Tuberculous chorioretinitis |
A18.54 | Tuberculous iridocyclitis |
B39.4 | Histoplasmosis capsulati, unspecified |
B39.5 | Histoplasmosis duboisii |
B39.9 | Histoplasmosis, unspecified |
B58.01 | Toxoplasma chorioretinitis |
C69.21 | Malignant neoplasm of right retina |
C69.22 | Malignant neoplasm of left retina |
C69.31 | Malignant neoplasm of right choroid |
C69.32 | Malignant neoplasm of left choroid |
C69.41 | Malignant neoplasm of right ciliary body |
C69.42 | Malignant neoplasm of left ciliary body |
C72.31 | Malignant neoplasm of right optic nerve |
C72.32 | Malignant neoplasm of left optic nerve |
C72.59 | Malignant neoplasm of other cranial nerves |
C79.89 | Secondary malignant neoplasm of other specified sites |
D31.21 | Benign neoplasm of right retina |
D31.22 | Benign neoplasm of left retina |
D31.31 | Benign neoplasm of right choroid |
D31.32 | Benign neoplasm of left choroid |
D31.41 | Benign neoplasm of right ciliary body |
D31.42 | Benign neoplasm of left ciliary body |
D33.3 | Benign neoplasm of cranial nerves |
E08.00 | Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
E08.01 | Diabetes mellitus due to underlying condition with hyperosmolarity with coma |
E08.10 | Diabetes mellitus due to underlying condition with ketoacidosis without coma |
E08.11 | Diabetes mellitus due to underlying condition with ketoacidosis with coma |
E08.21 | Diabetes mellitus due to underlying condition with diabetic nephropathy |
E08.22 | Diabetes mellitus due to underlying condition with diabetic chronic kidney disease |
E08.29 | Diabetes mellitus due to underlying condition with other diabetic kidney complication |
E08.311 | Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema |
E08.319 | Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema |
E08.3211 - E08.3213 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral |
E08.3291 - E08.3293 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral |
E08.3311 - E08.3313 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral |
E08.3391 - E08.3393 | Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral |
E08.3411 - E08.3413 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral |
E08.3491 - E08.3493 | Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral |
E08.3511 - E08.3513 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral |
E08.3521 - E08.3523 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral |
E08.3531 - E08.3533 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral |
E08.3541 - E08.3543 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral |
E08.3551 - E08.3553 | Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye - Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral |
E08.3591 - E08.3593 | Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye - Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral |
E08.36 | Diabetes mellitus due to underlying condition with diabetic cataract |
E08.37X1 - E08.37X3 | Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye - Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral |
E08.39 | Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication |
E08.41 | Diabetes mellitus due to underlying condition with diabetic mononeuropathy |
E08.42 | Diabetes mellitus due to underlying condition with diabetic polyneuropathy |
E08.43 | Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy |
E08.44 | Diabetes mellitus due to underlying condition with diabetic amyotrophy |
E08.49 | Diabetes mellitus due to underlying condition with other diabetic neurological complication |
E08.51 | Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene |
E08.52 | Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene |
E08.59 | Diabetes mellitus due to underlying condition with other circulatory complications |
E08.610 | Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy |
E08.618 | Diabetes mellitus due to underlying condition with other diabetic arthropathy |
E08.620 | Diabetes mellitus due to underlying condition with diabetic dermatitis |
E08.621 | Diabetes mellitus due to underlying condition with foot ulcer |
E08.622 | Diabetes mellitus due to underlying condition with other skin ulcer |
E08.628 | Diabetes mellitus due to underlying condition with other skin complications |
E08.630 | Diabetes mellitus due to underlying condition with periodontal disease |
E08.638 | Diabetes mellitus due to underlying condition with other oral complications |
E08.641 | Diabetes mellitus due to underlying condition with hypoglycemia with coma |
E08.649 | Diabetes mellitus due to underlying condition with hypoglycemia without coma |
E08.65 | Diabetes mellitus due to underlying condition with hyperglycemia |
E08.69 | Diabetes mellitus due to underlying condition with other specified complication |
E08.8 | Diabetes mellitus due to underlying condition with unspecified complications |
E08.9 | Diabetes mellitus due to underlying condition without complications |
E09.00 | Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
E09.01 | Drug or chemical induced diabetes mellitus with hyperosmolarity with coma |
E09.10 | Drug or chemical induced diabetes mellitus with ketoacidosis without coma |
E09.11 | Drug or chemical induced diabetes mellitus with ketoacidosis with coma |
E09.21 | Drug or chemical induced diabetes mellitus with diabetic nephropathy |
E09.22 | Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease |
E09.29 | Drug or chemical induced diabetes mellitus with other diabetic kidney complication |
E09.311 | Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema |
E09.319 | Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema |
E09.3211 - E09.3213 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral |
E09.3291 - E09.3293 | Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral |
E09.3311 - E09.3313 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral |
E09.3391 - E09.3393 | Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral |
E09.3411 - E09.3413 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral |
E09.3491 - E09.3493 | Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral |
E09.3511 - E09.3513 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral |
E09.3521 - E09.3523 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral |
E09.3531 - E09.3533 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral |
E09.3541 - E09.3543 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral |
E09.3551 - E09.3553 | Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral |
E09.3591 - E09.3593 | Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral |
E09.36 | Drug or chemical induced diabetes mellitus with diabetic cataract |
E09.37X1 - E09.37X3 | Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral |
E09.39 | Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication |
E09.41 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy |
E09.42 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy |
E09.43 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy |
E09.44 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy |
E09.49 | Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication |
E09.51 | Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene |
E09.52 | Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene |
E09.59 | Drug or chemical induced diabetes mellitus with other circulatory complications |
E09.610 | Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy |
E09.618 | Drug or chemical induced diabetes mellitus with other diabetic arthropathy |
E09.620 | Drug or chemical induced diabetes mellitus with diabetic dermatitis |
E09.621 | Drug or chemical induced diabetes mellitus with foot ulcer |
E09.622 | Drug or chemical induced diabetes mellitus with other skin ulcer |
E09.628 | Drug or chemical induced diabetes mellitus with other skin complications |
E09.630 | Drug or chemical induced diabetes mellitus with periodontal disease |
E09.638 | Drug or chemical induced diabetes mellitus with other oral complications |
E09.641 | Drug or chemical induced diabetes mellitus with hypoglycemia with coma |
E09.649 | Drug or chemical induced diabetes mellitus with hypoglycemia without coma |
E09.65 | Drug or chemical induced diabetes mellitus with hyperglycemia |
E09.69 | Drug or chemical induced diabetes mellitus with other specified complication |
E09.9 | Drug or chemical induced diabetes mellitus without complications |
E10.10 | Type 1 diabetes mellitus with ketoacidosis without coma |
E10.11 | Type 1 diabetes mellitus with ketoacidosis with coma |
E10.21 | Type 1 diabetes mellitus with diabetic nephropathy |
E10.22 | Type 1 diabetes mellitus with diabetic chronic kidney disease |
E10.29 | Type 1 diabetes mellitus with other diabetic kidney complication |
E10.311 | Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
E10.319 | Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema |
E10.3211 - E10.3213 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral |
E10.3291 - E10.3293 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral |
E10.3311 - E10.3313 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral |
E10.3391 - E10.3393 | Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral |
E10.3411 - E10.3413 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral |
E10.3491 - E10.3493 | Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral |
E10.3511 - E10.3513 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral |
E10.3521 - E10.3523 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral |
E10.3531 - E10.3533 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral |
E10.3541 - E10.3543 | Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral |
E10.3551 - E10.3553 | Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral |
E10.3591 - E10.3593 | Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral |
E10.36 | Type 1 diabetes mellitus with diabetic cataract |
E10.37X1 - E10.37X3 | Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral |
E10.39 | Type 1 diabetes mellitus with other diabetic ophthalmic complication |
E10.641 | Type 1 diabetes mellitus with hypoglycemia with coma |
E10.65 | Type 1 diabetes mellitus with hyperglycemia |
E10.65 | Type 1 diabetes mellitus with hyperglycemia |
E10.69 | Type 1 diabetes mellitus with other specified complication |
E10.9 | Type 1 diabetes mellitus without complications |
E11.00 | Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
E11.01 | Type 2 diabetes mellitus with hyperosmolarity with coma |
E11.21 | Type 2 diabetes mellitus with diabetic nephropathy |
E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease |
E11.29 | Type 2 diabetes mellitus with other diabetic kidney complication |
E11.311 | Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
E11.319 | Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema |
E11.3211 - E11.3213 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral |
E11.3291 - E11.3293 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral |
E11.3311 - E11.3313 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral |
E11.3391 - E11.3393 | Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral |
E11.3411 - E11.3413 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral |
E11.3491 - E11.3493 | Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral |
E11.3511 - E11.3513 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral |
E11.3521 - E11.3523 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral |
E11.3531 - E11.3533 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral |
E11.3541 - E11.3543 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral |
E11.3551 - E11.3553 | Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral |
E11.3591 - E11.3593 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral |
E11.36 | Type 2 diabetes mellitus with diabetic cataract |
E11.37X1 - E11.37X3 | Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral |
E11.39 | Type 2 diabetes mellitus with other diabetic ophthalmic complication |
E11.641 | Type 2 diabetes mellitus with hypoglycemia with coma |
E11.649 | Type 2 diabetes mellitus with hypoglycemia without coma |
E11.65 | Type 2 diabetes mellitus with hyperglycemia |
E11.65 | Type 2 diabetes mellitus with hyperglycemia |
E11.69 | Type 2 diabetes mellitus with other specified complication |
E11.9 | Type 2 diabetes mellitus without complications |
E13.00 | Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
E13.01 | Other specified diabetes mellitus with hyperosmolarity with coma |
E13.10 | Other specified diabetes mellitus with ketoacidosis without coma |
E13.11 | Other specified diabetes mellitus with ketoacidosis with coma |
E13.21 | Other specified diabetes mellitus with diabetic nephropathy |
E13.22 | Other specified diabetes mellitus with diabetic chronic kidney disease |
E13.29 | Other specified diabetes mellitus with other diabetic kidney complication |
E13.311 | Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema |
E13.319 | Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema |
E13.3211 - E13.3213 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral |
E13.3291 - E13.3293 | Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral |
E13.3311 - E13.3313 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral |
E13.3391 - E13.3393 | Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral |
E13.3411 - E13.3413 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral |
E13.3491 - E13.3493 | Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral |
E13.3511 - E13.3513 | Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral |
E13.3521 - E13.3523 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral |
E13.3531 - E13.3533 | Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral |
E13.3541 - E13.3543 | Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral |
E13.3551 - E13.3553 | Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye - Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral |
E13.3591 - E13.3593 | Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye - Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral |
E13.36 | Other specified diabetes mellitus with diabetic cataract |
E13.37X1 - E13.37X3 | Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye - Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral |
E13.39 | Other specified diabetes mellitus with other diabetic ophthalmic complication |
E13.40 | Other specified diabetes mellitus with diabetic neuropathy, unspecified |
E13.41 | Other specified diabetes mellitus with diabetic mononeuropathy |
E13.42 | Other specified diabetes mellitus with diabetic polyneuropathy |
E13.43 | Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy |
E13.44 | Other specified diabetes mellitus with diabetic amyotrophy |
E13.49 | Other specified diabetes mellitus with other diabetic neurological complication |
E13.51 | Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene |
E13.52 | Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene |
E13.59 | Other specified diabetes mellitus with other circulatory complications |
E13.610 | Other specified diabetes mellitus with diabetic neuropathic arthropathy |
E13.618 | Other specified diabetes mellitus with other diabetic arthropathy |
E13.620 | Other specified diabetes mellitus with diabetic dermatitis |
E13.621 | Other specified diabetes mellitus with foot ulcer |
E13.622 | Other specified diabetes mellitus with other skin ulcer |
E13.628 | Other specified diabetes mellitus with other skin complications |
E13.630 | Other specified diabetes mellitus with periodontal disease |
E13.638 | Other specified diabetes mellitus with other oral complications |
E13.641 | Other specified diabetes mellitus with hypoglycemia with coma |
E13.649 | Other specified diabetes mellitus with hypoglycemia without coma |
E13.65 | Other specified diabetes mellitus with hyperglycemia |
E13.69 | Other specified diabetes mellitus with other specified complication |
E13.9 | Other specified diabetes mellitus without complications |
G45.3 | Amaurosis fugax |
H05.30 | Unspecified deformity of orbit |
H05.311 | Atrophy of right orbit |
H05.312 | Atrophy of left orbit |
H05.313 | Atrophy of bilateral orbit |
H05.321 | Deformity of right orbit due to bone disease |
H05.322 | Deformity of left orbit due to bone disease |
H05.323 | Deformity of bilateral orbits due to bone disease |
H05.331 | Deformity of right orbit due to trauma or surgery |
H05.332 | Deformity of left orbit due to trauma or surgery |
H05.333 | Deformity of bilateral orbits due to trauma or surgery |
H05.341 | Enlargement of right orbit |
H05.342 | Enlargement of left orbit |
H05.343 | Enlargement of bilateral orbits |
H05.351 | Exostosis of right orbit |
H05.352 | Exostosis of left orbit |
H05.353 | Exostosis of bilateral orbits |
H05.411 | Enophthalmos due to atrophy of orbital tissue, right eye |
H05.412 | Enophthalmos due to atrophy of orbital tissue, left eye |
H05.413 | Enophthalmos due to atrophy of orbital tissue, bilateral |
H05.421 | Enophthalmos due to trauma or surgery, right eye |
H05.422 | Enophthalmos due to trauma or surgery, left eye |
H05.423 | Enophthalmos due to trauma or surgery, bilateral |
H05.51 | Retained (old) foreign body following penetrating wound of right orbit |
H05.52 | Retained (old) foreign body following penetrating wound of left orbit |
H05.53 | Retained (old) foreign body following penetrating wound of bilateral orbits |
H05.89 | Other disorders of orbit |
H15.031 | Posterior scleritis, right eye |
H15.032 | Posterior scleritis, left eye |
H15.033 | Posterior scleritis, bilateral |
H16.241 | Ophthalmia nodosa, right eye |
H16.242 | Ophthalmia nodosa, left eye |
H16.243 | Ophthalmia nodosa, bilateral |
H20.00 | Unspecified acute and subacute iridocyclitis |
H20.011 | Primary iridocyclitis, right eye |
H20.012 | Primary iridocyclitis, left eye |
H20.013 | Primary iridocyclitis, bilateral |
H20.021 | Recurrent acute iridocyclitis, right eye |
H20.022 | Recurrent acute iridocyclitis, left eye |
H20.023 | Recurrent acute iridocyclitis, bilateral |
H20.031 | Secondary infectious iridocyclitis, right eye |
H20.032 | Secondary infectious iridocyclitis, left eye |
H20.033 | Secondary infectious iridocyclitis, bilateral |
H20.041 | Secondary noninfectious iridocyclitis, right eye |
H20.042 | Secondary noninfectious iridocyclitis, left eye |
H20.043 | Secondary noninfectious iridocyclitis, bilateral |
H20.11 | Chronic iridocyclitis, right eye |
H20.12 | Chronic iridocyclitis, left eye |
H20.13 | Chronic iridocyclitis, bilateral |
H20.21 | Lens-induced iridocyclitis, right eye |
H20.22 | Lens-induced iridocyclitis, left eye |
H20.23 | Lens-induced iridocyclitis, bilateral |
H20.811 | Fuchs' heterochromic cyclitis, right eye |
H20.812 | Fuchs' heterochromic cyclitis, left eye |
H20.813 | Fuchs' heterochromic cyclitis, bilateral |
H20.821 | Vogt-Koyanagi syndrome, right eye |
H20.822 | Vogt-Koyanagi syndrome, left eye |
H20.823 | Vogt-Koyanagi syndrome, bilateral |
H21.01 | Hyphema, right eye |
H21.02 | Hyphema, left eye |
H21.03 | Hyphema, bilateral |
H21.1X1 | Other vascular disorders of iris and ciliary body, right eye |
H21.1X2 | Other vascular disorders of iris and ciliary body, left eye |
H21.1X3 | Other vascular disorders of iris and ciliary body, bilateral |
H21.211 | Degeneration of chamber angle, right eye |
H21.212 | Degeneration of chamber angle, left eye |
H21.213 | Degeneration of chamber angle, bilateral |
H21.221 | Degeneration of ciliary body, right eye |
H21.222 | Degeneration of ciliary body, left eye |
H21.223 | Degeneration of ciliary body, bilateral |
H21.231 | Degeneration of iris (pigmentary), right eye |
H21.232 | Degeneration of iris (pigmentary), left eye |
H21.233 | Degeneration of iris (pigmentary), bilateral |
H21.241 | Degeneration of pupillary margin, right eye |
H21.242 | Degeneration of pupillary margin, left eye |
H21.243 | Degeneration of pupillary margin, bilateral |
H21.251 | Iridoschisis, right eye |
H21.252 | Iridoschisis, left eye |
H21.253 | Iridoschisis, bilateral |
H21.261 | Iris atrophy (essential) (progressive), right eye |
H21.262 | Iris atrophy (essential) (progressive), left eye |
H21.263 | Iris atrophy (essential) (progressive), bilateral |
H21.271 | Miotic pupillary cyst, right eye |
H21.272 | Miotic pupillary cyst, left eye |
H21.273 | Miotic pupillary cyst, bilateral |
H21.29 | Other iris atrophy |
H21.301 | Idiopathic cysts of iris, ciliary body or anterior chamber, right eye |
H21.302 | Idiopathic cysts of iris, ciliary body or anterior chamber, left eye |
H21.303 | Idiopathic cysts of iris, ciliary body or anterior chamber, bilateral |
H21.311 | Exudative cysts of iris or anterior chamber, right eye |
H21.312 | Exudative cysts of iris or anterior chamber, left eye |
H21.313 | Exudative cysts of iris or anterior chamber, bilateral |
H21.321 | Implantation cysts of iris, ciliary body or anterior chamber, right eye |
H21.322 | Implantation cysts of iris, ciliary body or anterior chamber, left eye |
H21.323 | Implantation cysts of iris, ciliary body or anterior chamber, bilateral |
H21.331 | Parasitic cyst of iris, ciliary body or anterior chamber, right eye |
H21.332 | Parasitic cyst of iris, ciliary body or anterior chamber, left eye |
H21.333 | Parasitic cyst of iris, ciliary body or anterior chamber, bilateral |
H21.341 | Primary cyst of pars plana, right eye |
H21.342 | Primary cyst of pars plana, left eye |
H21.343 | Primary cyst of pars plana, bilateral |
H21.351 | Exudative cyst of pars plana, right eye |
H21.352 | Exudative cyst of pars plana, left eye |
H21.353 | Exudative cyst of pars plana, bilateral |
H21.41 | Pupillary membranes, right eye |
H21.42 | Pupillary membranes, left eye |
H21.43 | Pupillary membranes, bilateral |
H21.511 | Anterior synechiae (iris), right eye |
H21.512 | Anterior synechiae (iris), left eye |
H21.513 | Anterior synechiae (iris), bilateral |
H21.521 | Goniosynechiae, right eye |
H21.522 | Goniosynechiae, left eye |
H21.523 | Goniosynechiae, bilateral |
H21.531 | Iridodialysis, right eye |
H21.532 | Iridodialysis, left eye |
H21.533 | Iridodialysis, bilateral |
H21.541 | Posterior synechiae (iris), right eye |
H21.542 | Posterior synechiae (iris), left eye |
H21.543 | Posterior synechiae (iris), bilateral |
H21.551 | Recession of chamber angle, right eye |
H21.552 | Recession of chamber angle, left eye |
H21.553 | Recession of chamber angle, bilateral |
H21.561 | Pupillary abnormality, right eye |
H21.562 | Pupillary abnormality, left eye |
H21.563 | Pupillary abnormality, bilateral |
H21.81 | Floppy iris syndrome |
H21.82 | Plateau iris syndrome (post-iridectomy) (postprocedural) |
H21.89 | Other specified disorders of iris and ciliary body |
H22 | Disorders of iris and ciliary body in diseases classified elsewhere |
H27.111 | Subluxation of lens, right eye |
H27.112 | Subluxation of lens, left eye |
H27.113 | Subluxation of lens, bilateral |
H27.131 | Posterior dislocation of lens, right eye |
H27.132 | Posterior dislocation of lens, left eye |
H27.133 | Posterior dislocation of lens, bilateral |
H30.011 | Focal chorioretinal inflammation, juxtapapillary, right eye |
H30.012 | Focal chorioretinal inflammation, juxtapapillary, left eye |
H30.013 | Focal chorioretinal inflammation, juxtapapillary, bilateral |
H30.021 | Focal chorioretinal inflammation of posterior pole, right eye |
H30.022 | Focal chorioretinal inflammation of posterior pole, left eye |
H30.023 | Focal chorioretinal inflammation of posterior pole, bilateral |
H30.031 | Focal chorioretinal inflammation, peripheral, right eye |
H30.032 | Focal chorioretinal inflammation, peripheral, left eye |
H30.033 | Focal chorioretinal inflammation, peripheral, bilateral |
H30.041 | Focal chorioretinal inflammation, macular or paramacular, right eye |
H30.042 | Focal chorioretinal inflammation, macular or paramacular, left eye |
H30.043 | Focal chorioretinal inflammation, macular or paramacular, bilateral |
H30.111 | Disseminated chorioretinal inflammation of posterior pole, right eye |
H30.112 | Disseminated chorioretinal inflammation of posterior pole, left eye |
H30.113 | Disseminated chorioretinal inflammation of posterior pole, bilateral |
H30.121 | Disseminated chorioretinal inflammation, peripheral right eye |
H30.122 | Disseminated chorioretinal inflammation, peripheral, left eye |
H30.123 | Disseminated chorioretinal inflammation, peripheral, bilateral |
H30.131 | Disseminated chorioretinal inflammation, generalized, right eye |
H30.132 | Disseminated chorioretinal inflammation, generalized, left eye |
H30.133 | Disseminated chorioretinal inflammation, generalized, bilateral |
H30.141 | Acute posterior multifocal placoid pigment epitheliopathy, right eye |
H30.142 | Acute posterior multifocal placoid pigment epitheliopathy, left eye |
H30.143 | Acute posterior multifocal placoid pigment epitheliopathy, bilateral |
H30.21 | Posterior cyclitis, right eye |
H30.22 | Posterior cyclitis, left eye |
H30.23 | Posterior cyclitis, bilateral |
H30.811 | Harada's disease, right eye |
H30.812 | Harada's disease, left eye |
H30.813 | Harada's disease, bilateral |
H30.891 | Other chorioretinal inflammations, right eye |
H30.892 | Other chorioretinal inflammations, left eye |
H30.893 | Other chorioretinal inflammations, bilateral |
H30.91 | Unspecified chorioretinal inflammation, right eye |
H30.92 | Unspecified chorioretinal inflammation, left eye |
H30.93 | Unspecified chorioretinal inflammation, bilateral |
H31.001 | Unspecified chorioretinal scars, right eye |
H31.002 | Unspecified chorioretinal scars, left eye |
H31.003 | Unspecified chorioretinal scars, bilateral |
H31.011 | Macula scars of posterior pole (postinflammatory) (post-traumatic), right eye |
H31.012 | Macula scars of posterior pole (postinflammatory) (post-traumatic), left eye |
H31.013 | Macula scars of posterior pole (postinflammatory) (post-traumatic), bilateral |
H31.021 | Solar retinopathy, right eye |
H31.022 | Solar retinopathy, left eye |
H31.023 | Solar retinopathy, bilateral |
H31.091 | Other chorioretinal scars, right eye |
H31.092 | Other chorioretinal scars, left eye |
H31.093 | Other chorioretinal scars, bilateral |
H31.101 | Choroidal degeneration, unspecified, right eye |
H31.102 | Choroidal degeneration, unspecified, left eye |
H31.103 | Choroidal degeneration, unspecified, bilateral |
H31.111 | Age-related choroidal atrophy, right eye |
H31.112 | Age-related choroidal atrophy, left eye |
H31.113 | Age-related choroidal atrophy, bilateral |
H31.121 | Diffuse secondary atrophy of choroid, right eye |
H31.122 | Diffuse secondary atrophy of choroid, left eye |
H31.123 | Diffuse secondary atrophy of choroid, bilateral |
H31.20 | Hereditary choroidal dystrophy, unspecified |
H31.21 | Choroideremia |
H31.22 | Choroidal dystrophy (central areolar) (generalized) (peripapillary) |
H31.23 | Gyrate atrophy, choroid |
H31.29 | Other hereditary choroidal dystrophy |
H31.301 | Unspecified choroidal hemorrhage, right eye |
H31.302 | Unspecified choroidal hemorrhage, left eye |
H31.303 | Unspecified choroidal hemorrhage, bilateral |
H31.311 | Expulsive choroidal hemorrhage, right eye |
H31.312 | Expulsive choroidal hemorrhage, left eye |
H31.313 | Expulsive choroidal hemorrhage, bilateral |
H31.321 | Choroidal rupture, right eye |
H31.322 | Choroidal rupture, left eye |
H31.323 | Choroidal rupture, bilateral |
H31.401 | Unspecified choroidal detachment, right eye |
H31.402 | Unspecified choroidal detachment, left eye |
H31.403 | Unspecified choroidal detachment, bilateral |
H31.411 | Hemorrhagic choroidal detachment, right eye |
H31.412 | Hemorrhagic choroidal detachment, left eye |
H31.413 | Hemorrhagic choroidal detachment, bilateral |
H31.421 | Serous choroidal detachment, right eye |
H31.422 | Serous choroidal detachment, left eye |
H31.423 | Serous choroidal detachment, bilateral |
H31.8 | Other specified disorders of choroid |
H31.9 | Unspecified disorder of choroid |
H32 | Chorioretinal disorders in diseases classified elsewhere |
H33.001 | Unspecified retinal detachment with retinal break, right eye |
H33.002 | Unspecified retinal detachment with retinal break, left eye |
H33.003 | Unspecified retinal detachment with retinal break, bilateral |
H33.011 | Retinal detachment with single break, right eye |
H33.012 | Retinal detachment with single break, left eye |
H33.013 | Retinal detachment with single break, bilateral |
H33.021 | Retinal detachment with multiple breaks, right eye |
H33.022 | Retinal detachment with multiple breaks, left eye |
H33.023 | Retinal detachment with multiple breaks, bilateral |
H33.031 | Retinal detachment with giant retinal tear, right eye |
H33.032 | Retinal detachment with giant retinal tear, left eye |
H33.033 | Retinal detachment with giant retinal tear, bilateral |
H33.041 | Retinal detachment with retinal dialysis, right eye |
H33.042 | Retinal detachment with retinal dialysis, left eye |
H33.043 | Retinal detachment with retinal dialysis, bilateral |
H33.051 | Total retinal detachment, right eye |
H33.052 | Total retinal detachment, left eye |
H33.053 | Total retinal detachment, bilateral |
H33.101 | Unspecified retinoschisis, right eye |
H33.102 | Unspecified retinoschisis, left eye |
H33.103 | Unspecified retinoschisis, bilateral |
H33.111 | Cyst of ora serrata, right eye |
H33.112 | Cyst of ora serrata, left eye |
H33.113 | Cyst of ora serrata, bilateral |
H33.121 | Parasitic cyst of retina, right eye |
H33.122 | Parasitic cyst of retina, left eye |
H33.123 | Parasitic cyst of retina, bilateral |
H33.191 | Other retinoschisis and retinal cysts, right eye |
H33.192 | Other retinoschisis and retinal cysts, left eye |
H33.193 | Other retinoschisis and retinal cysts, bilateral |
H33.21 | Serous retinal detachment, right eye |
H33.22 | Serous retinal detachment, left eye |
H33.23 | Serous retinal detachment, bilateral |
H33.301 | Unspecified retinal break, right eye |
H33.302 | Unspecified retinal break, left eye |
H33.303 | Unspecified retinal break, bilateral |
H33.311 | Horseshoe tear of retina without detachment, right eye |
H33.312 | Horseshoe tear of retina without detachment, left eye |
H33.313 | Horseshoe tear of retina without detachment, bilateral |
H33.321 | Round hole, right eye |
H33.322 | Round hole, left eye |
H33.323 | Round hole, bilateral |
H33.331 | Multiple defects of retina without detachment, right eye |
H33.332 | Multiple defects of retina without detachment, left eye |
H33.333 | Multiple defects of retina without detachment, bilateral |
H33.41 | Traction detachment of retina, right eye |
H33.42 | Traction detachment of retina, left eye |
H33.43 | Traction detachment of retina, bilateral |
H33.8 | Other retinal detachments |
H34.01 | Transient retinal artery occlusion, right eye |
H34.02 | Transient retinal artery occlusion, left eye |
H34.03 | Transient retinal artery occlusion, bilateral |
H34.11 | Central retinal artery occlusion, right eye |
H34.12 | Central retinal artery occlusion, left eye |
H34.13 | Central retinal artery occlusion, bilateral |
H34.211 | Partial retinal artery occlusion, right eye |
H34.212 | Partial retinal artery occlusion, left eye |
H34.213 | Partial retinal artery occlusion, bilateral |
H34.231 | Retinal artery branch occlusion, right eye |
H34.232 | Retinal artery branch occlusion, left eye |
H34.233 | Retinal artery branch occlusion, bilateral |
H34.8110 - H34.8112 | Central retinal vein occlusion, right eye, with macular edema - Central retinal vein occlusion, right eye, stable |
H34.8120 - H34.8122 | Central retinal vein occlusion, left eye, with macular edema - Central retinal vein occlusion, left eye, stable |
H34.8130 - H34.8132 | Central retinal vein occlusion, bilateral, with macular edema - Central retinal vein occlusion, bilateral, stable |
H34.821 | Venous engorgement, right eye |
H34.822 | Venous engorgement, left eye |
H34.823 | Venous engorgement, bilateral |
H34.8310 - H34.8312 | Tributary (branch) retinal vein occlusion, right eye, with macular edema - Tributary (branch) retinal vein occlusion, right eye, stable |
H34.8320 - H34.8322 | Tributary (branch) retinal vein occlusion, left eye, with macular edema - Tributary (branch) retinal vein occlusion, left eye, stable |
H34.8330 - H34.8332 | Tributary (branch) retinal vein occlusion, bilateral, with macular edema - Tributary (branch) retinal vein occlusion, bilateral, stable |
H34.9 | Unspecified retinal vascular occlusion |
H35.00 | Unspecified background retinopathy |
H35.011 | Changes in retinal vascular appearance, right eye |
H35.012 | Changes in retinal vascular appearance, left eye |
H35.013 | Changes in retinal vascular appearance, bilateral |
H35.021 | Exudative retinopathy, right eye |
H35.022 | Exudative retinopathy, left eye |
H35.023 | Exudative retinopathy, bilateral |
H35.031 | Hypertensive retinopathy, right eye |
H35.032 | Hypertensive retinopathy, left eye |
H35.033 | Hypertensive retinopathy, bilateral |
H35.041 | Retinal micro-aneurysms, unspecified, right eye |
H35.042 | Retinal micro-aneurysms, unspecified, left eye |
H35.043 | Retinal micro-aneurysms, unspecified, bilateral |
H35.051 | Retinal neovascularization, unspecified, right eye |
H35.052 | Retinal neovascularization, unspecified, left eye |
H35.053 | Retinal neovascularization, unspecified, bilateral |
H35.061 | Retinal vasculitis, right eye |
H35.062 | Retinal vasculitis, left eye |
H35.063 | Retinal vasculitis, bilateral |
H35.071 | Retinal telangiectasis, right eye |
H35.072 | Retinal telangiectasis, left eye |
H35.073 | Retinal telangiectasis, bilateral |
H35.09 | Other intraretinal microvascular abnormalities |
H35.101 | Retinopathy of prematurity, unspecified, right eye |
H35.102 | Retinopathy of prematurity, unspecified, left eye |
H35.103 | Retinopathy of prematurity, unspecified, bilateral |
H35.111 | Retinopathy of prematurity, stage 0, right eye |
H35.112 | Retinopathy of prematurity, stage 0, left eye |
H35.113 | Retinopathy of prematurity, stage 0, bilateral |
H35.121 | Retinopathy of prematurity, stage 1, right eye |
H35.122 | Retinopathy of prematurity, stage 1, left eye |
H35.123 | Retinopathy of prematurity, stage 1, bilateral |
H35.131 | Retinopathy of prematurity, stage 2, right eye |
H35.132 | Retinopathy of prematurity, stage 2, left eye |
H35.133 | Retinopathy of prematurity, stage 2, bilateral |
H35.141 | Retinopathy of prematurity, stage 3, right eye |
H35.142 | Retinopathy of prematurity, stage 3, left eye |
H35.143 | Retinopathy of prematurity, stage 3, bilateral |
H35.151 | Retinopathy of prematurity, stage 4, right eye |
H35.152 | Retinopathy of prematurity, stage 4, left eye |
H35.153 | Retinopathy of prematurity, stage 4, bilateral |
H35.161 | Retinopathy of prematurity, stage 5, right eye |
H35.162 | Retinopathy of prematurity, stage 5, left eye |
H35.163 | Retinopathy of prematurity, stage 5, bilateral |
H35.171 | Retrolental fibroplasia, right eye |
H35.172 | Retrolental fibroplasia, left eye |
H35.173 | Retrolental fibroplasia, bilateral |
H35.21 | Other non-diabetic proliferative retinopathy, right eye |
H35.22 | Other non-diabetic proliferative retinopathy, left eye |
H35.23 | Other non-diabetic proliferative retinopathy, bilateral |
H35.30 | Unspecified macular degeneration |
H35.3110 - H35.3114 | Nonexudative age-related macular degeneration, right eye, stage unspecified - Nonexudative age-related macular degeneration, right eye, advanced atrophic with subfoveal involvement |
H35.3120 - H35.3124 | Nonexudative age-related macular degeneration, left eye, stage unspecified - Nonexudative age-related macular degeneration, left eye, advanced atrophic with subfoveal involvement |
H35.3130 - H35.3134 | Nonexudative age-related macular degeneration, bilateral, stage unspecified - Nonexudative age-related macular degeneration, bilateral, advanced atrophic with subfoveal involvement |
H35.3210 - H35.3213 | Exudative age-related macular degeneration, right eye, stage unspecified - Exudative age-related macular degeneration, right eye, with inactive scar |
H35.3220 - H35.3223 | Exudative age-related macular degeneration, left eye, stage unspecified - Exudative age-related macular degeneration, left eye, with inactive scar |
H35.3230 - H35.3233 | Exudative age-related macular degeneration, bilateral, stage unspecified - Exudative age-related macular degeneration, bilateral, with inactive scar |
H35.33 | Angioid streaks of macula |
H35.341 | Macular cyst, hole, or pseudohole, right eye |
H35.342 | Macular cyst, hole, or pseudohole, left eye |
H35.343 | Macular cyst, hole, or pseudohole, bilateral |
H35.351 | Cystoid macular degeneration, right eye |
H35.352 | Cystoid macular degeneration, left eye |
H35.353 | Cystoid macular degeneration, bilateral |
H35.361 | Drusen (degenerative) of macula, right eye |
H35.362 | Drusen (degenerative) of macula, left eye |
H35.363 | Drusen (degenerative) of macula, bilateral |
H35.371 | Puckering of macula, right eye |
H35.372 | Puckering of macula, left eye |
H35.373 | Puckering of macula, bilateral |
H35.381 | Toxic maculopathy, right eye |
H35.382 | Toxic maculopathy, left eye |
H35.383 | Toxic maculopathy, bilateral |
H35.40 | Unspecified peripheral retinal degeneration |
H35.411 | Lattice degeneration of retina, right eye |
H35.412 | Lattice degeneration of retina, left eye |
H35.413 | Lattice degeneration of retina, bilateral |
H35.421 | Microcystoid degeneration of retina, right eye |
H35.422 | Microcystoid degeneration of retina, left eye |
H35.423 | Microcystoid degeneration of retina, bilateral |
H35.431 | Paving stone degeneration of retina, right eye |
H35.432 | Paving stone degeneration of retina, left eye |
H35.433 | Paving stone degeneration of retina, bilateral |
H35.441 | Age-related reticular degeneration of retina, right eye |
H35.442 | Age-related reticular degeneration of retina, left eye |
H35.443 | Age-related reticular degeneration of retina, bilateral |
H35.451 | Secondary pigmentary degeneration, right eye |
H35.452 | Secondary pigmentary degeneration, left eye |
H35.453 | Secondary pigmentary degeneration, bilateral |
H35.461 | Secondary vitreoretinal degeneration, right eye |
H35.462 | Secondary vitreoretinal degeneration, left eye |
H35.463 | Secondary vitreoretinal degeneration, bilateral |
H35.50 | Unspecified hereditary retinal dystrophy |
H35.51 | Vitreoretinal dystrophy |
H35.52 | Pigmentary retinal dystrophy |
H35.53 | Other dystrophies primarily involving the sensory retina |
H35.54 | Dystrophies primarily involving the retinal pigment epithelium |
H35.61 | Retinal hemorrhage, right eye |
H35.62 | Retinal hemorrhage, left eye |
H35.63 | Retinal hemorrhage, bilateral |
H35.70 | Unspecified separation of retinal layers |
H35.711 | Central serous chorioretinopathy, right eye |
H35.712 | Central serous chorioretinopathy, left eye |
H35.713 | Central serous chorioretinopathy, bilateral |
H35.721 | Serous detachment of retinal pigment epithelium, right eye |
H35.722 | Serous detachment of retinal pigment epithelium, left eye |
H35.723 | Serous detachment of retinal pigment epithelium, bilateral |
H35.731 | Hemorrhagic detachment of retinal pigment epithelium, right eye |
H35.732 | Hemorrhagic detachment of retinal pigment epithelium, left eye |
H35.733 | Hemorrhagic detachment of retinal pigment epithelium, bilateral |
H35.81 | Retinal edema |
H35.82 | Retinal ischemia |
H35.89 | Other specified retinal disorders |
H36 | Retinal disorders in diseases classified elsewhere |
H40.001 | Preglaucoma, unspecified, right eye |
H40.002 | Preglaucoma, unspecified, left eye |
H40.003 | Preglaucoma, unspecified, bilateral |
H40.011 | Open angle with borderline findings, low risk, right eye |
H40.012 | Open angle with borderline findings, low risk, left eye |
H40.013 | Open angle with borderline findings, low risk, bilateral |
H40.021 | Open angle with borderline findings, high risk, right eye |
H40.022 | Open angle with borderline findings, high risk, left eye |
H40.023 | Open angle with borderline findings, high risk, bilateral |
H40.031 | Anatomical narrow angle, right eye |
H40.032 | Anatomical narrow angle, left eye |
H40.033 | Anatomical narrow angle, bilateral |
H40.041 | Steroid responder, right eye |
H40.042 | Steroid responder, left eye |
H40.043 | Steroid responder, bilateral |
H40.051 | Ocular hypertension, right eye |
H40.052 | Ocular hypertension, left eye |
H40.053 | Ocular hypertension, bilateral |
H40.061 | Primary angle closure without glaucoma damage, right eye |
H40.062 | Primary angle closure without glaucoma damage, left eye |
H40.063 | Primary angle closure without glaucoma damage, bilateral |
H40.10X0 | Unspecified open-angle glaucoma, stage unspecified |
H40.10X1 | Unspecified open-angle glaucoma, mild stage |
H40.10X2 | Unspecified open-angle glaucoma, moderate stage |
H40.10X3 | Unspecified open-angle glaucoma, severe stage |
H40.10X4 | Unspecified open-angle glaucoma, indeterminate stage |
H40.1110 - H40.1114 | Primary open-angle glaucoma, right eye, stage unspecified - Primary open-angle glaucoma, right eye, indeterminate stage |
H40.1120 - H40.1124 | Primary open-angle glaucoma, left eye, stage unspecified - Primary open-angle glaucoma, left eye, indeterminate stage |
H40.1130 - H40.1134 | Primary open-angle glaucoma, bilateral, stage unspecified - Primary open-angle glaucoma, bilateral, indeterminate stage |
H40.1190 - H40.1194 | Primary open-angle glaucoma, unspecified eye, stage unspecified - Primary open-angle glaucoma, unspecified eye, indeterminate stage |
H40.1210 | Low-tension glaucoma, right eye, stage unspecified |
H40.1211 | Low-tension glaucoma, right eye, mild stage |
H40.1212 | Low-tension glaucoma, right eye, moderate stage |
H40.1213 | Low-tension glaucoma, right eye, severe stage |
H40.1214 | Low-tension glaucoma, right eye, indeterminate stage |
H40.1220 | Low-tension glaucoma, left eye, stage unspecified |
H40.1221 | Low-tension glaucoma, left eye, mild stage |
H40.1222 | Low-tension glaucoma, left eye, moderate stage |
H40.1223 | Low-tension glaucoma, left eye, severe stage |
H40.1224 | Low-tension glaucoma, left eye, indeterminate stage |
H40.1230 | Low-tension glaucoma, bilateral, stage unspecified |
H40.1231 | Low-tension glaucoma, bilateral, mild stage |
H40.1232 | Low-tension glaucoma, bilateral, moderate stage |
H40.1233 | Low-tension glaucoma, bilateral, severe stage |
H40.1234 | Low-tension glaucoma, bilateral, indeterminate stage |
H40.1310 | Pigmentary glaucoma, right eye, stage unspecified |
H40.1311 | Pigmentary glaucoma, right eye, mild stage |
H40.1312 | Pigmentary glaucoma, right eye, moderate stage |
H40.1313 | Pigmentary glaucoma, right eye, severe stage |
H40.1314 | Pigmentary glaucoma, right eye, indeterminate stage |
H40.1320 | Pigmentary glaucoma, left eye, stage unspecified |
H40.1321 | Pigmentary glaucoma, left eye, mild stage |
H40.1322 | Pigmentary glaucoma, left eye, moderate stage |
H40.1323 | Pigmentary glaucoma, left eye, severe stage |
H40.1324 | Pigmentary glaucoma, left eye, indeterminate stage |
H40.1330 | Pigmentary glaucoma, bilateral, stage unspecified |
H40.1331 | Pigmentary glaucoma, bilateral, mild stage |
H40.1332 | Pigmentary glaucoma, bilateral, moderate stage |
H40.1333 | Pigmentary glaucoma, bilateral, severe stage |
H40.1334 | Pigmentary glaucoma, bilateral, indeterminate stage |
H40.1410 | Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified |
H40.1411 | Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage |
H40.1412 | Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage |
H40.1413 | Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage |
H40.1414 | Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage |
H40.1420 | Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified |
H40.1421 | Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage |
H40.1422 | Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage |
H40.1423 | Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage |
H40.1424 | Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage |
H40.1430 | Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified |
H40.1431 | Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage |
H40.1432 | Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage |
H40.1433 | Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage |
H40.1434 | Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage |
H40.151 | Residual stage of open-angle glaucoma, right eye |
H40.152 | Residual stage of open-angle glaucoma, left eye |
H40.153 | Residual stage of open-angle glaucoma, bilateral |
H40.20X0 | Unspecified primary angle-closure glaucoma, stage unspecified |
H40.20X1 | Unspecified primary angle-closure glaucoma, mild stage |
H40.20X2 | Unspecified primary angle-closure glaucoma, moderate stage |
H40.20X3 | Unspecified primary angle-closure glaucoma, severe stage |
H40.20X4 | Unspecified primary angle-closure glaucoma, indeterminate stage |
H40.211 | Acute angle-closure glaucoma, right eye |
H40.212 | Acute angle-closure glaucoma, left eye |
H40.213 | Acute angle-closure glaucoma, bilateral |
H40.2210 | Chronic angle-closure glaucoma, right eye, stage unspecified |
H40.2211 | Chronic angle-closure glaucoma, right eye, mild stage |
H40.2212 | Chronic angle-closure glaucoma, right eye, moderate stage |
H40.2213 | Chronic angle-closure glaucoma, right eye, severe stage |
H40.2214 | Chronic angle-closure glaucoma, right eye, indeterminate stage |
H40.2220 | Chronic angle-closure glaucoma, left eye, stage unspecified |
H40.2221 | Chronic angle-closure glaucoma, left eye, mild stage |
H40.2222 | Chronic angle-closure glaucoma, left eye, moderate stage |
H40.2223 | Chronic angle-closure glaucoma, left eye, severe stage |
H40.2224 | Chronic angle-closure glaucoma, left eye, indeterminate stage |
H40.2230 | Chronic angle-closure glaucoma, bilateral, stage unspecified |
H40.2231 | Chronic angle-closure glaucoma, bilateral, mild stage |
H40.2232 | Chronic angle-closure glaucoma, bilateral, moderate stage |
H40.2233 | Chronic angle-closure glaucoma, bilateral, severe stage |
H40.2234 | Chronic angle-closure glaucoma, bilateral, indeterminate stage |
H40.231 | Intermittent angle-closure glaucoma, right eye |
H40.232 | Intermittent angle-closure glaucoma, left eye |
H40.233 | Intermittent angle-closure glaucoma, bilateral |
H40.241 | Residual stage of angle-closure glaucoma, right eye |
H40.242 | Residual stage of angle-closure glaucoma, left eye |
H40.243 | Residual stage of angle-closure glaucoma, bilateral |
H40.31X0 | Glaucoma secondary to eye trauma, right eye, stage unspecified |
H40.31X1 | Glaucoma secondary to eye trauma, right eye, mild stage |
H40.31X2 | Glaucoma secondary to eye trauma, right eye, moderate stage |
H40.31X3 | Glaucoma secondary to eye trauma, right eye, severe stage |
H40.31X4 | Glaucoma secondary to eye trauma, right eye, indeterminate stage |
H40.32X0 | Glaucoma secondary to eye trauma, left eye, stage unspecified |
H40.32X1 | Glaucoma secondary to eye trauma, left eye, mild stage |
H40.32X2 | Glaucoma secondary to eye trauma, left eye, moderate stage |
H40.32X3 | Glaucoma secondary to eye trauma, left eye, severe stage |
H40.32X4 | Glaucoma secondary to eye trauma, left eye, indeterminate stage |
H40.33X0 | Glaucoma secondary to eye trauma, bilateral, stage unspecified |
H40.33X1 | Glaucoma secondary to eye trauma, bilateral, mild stage |
H40.33X2 | Glaucoma secondary to eye trauma, bilateral, moderate stage |
H40.33X3 | Glaucoma secondary to eye trauma, bilateral, severe stage |
H40.33X4 | Glaucoma secondary to eye trauma, bilateral, indeterminate stage |
H40.41X0 | Glaucoma secondary to eye inflammation, right eye, stage unspecified |
H40.41X1 | Glaucoma secondary to eye inflammation, right eye, mild stage |
H40.41X2 | Glaucoma secondary to eye inflammation, right eye, moderate stage |
H40.41X3 | Glaucoma secondary to eye inflammation, right eye, severe stage |
H40.41X4 | Glaucoma secondary to eye inflammation, right eye, indeterminate stage |
H40.42X0 | Glaucoma secondary to eye inflammation, left eye, stage unspecified |
H40.42X1 | Glaucoma secondary to eye inflammation, left eye, mild stage |
H40.42X2 | Glaucoma secondary to eye inflammation, left eye, moderate stage |
H40.42X3 | Glaucoma secondary to eye inflammation, left eye, severe stage |
H40.42X4 | Glaucoma secondary to eye inflammation, left eye, indeterminate stage |
H40.43X0 | Glaucoma secondary to eye inflammation, bilateral, stage unspecified |
H40.43X1 | Glaucoma secondary to eye inflammation, bilateral, mild stage |
H40.43X2 | Glaucoma secondary to eye inflammation, bilateral, moderate stage |
H40.43X3 | Glaucoma secondary to eye inflammation, bilateral, severe stage |
H40.43X4 | Glaucoma secondary to eye inflammation, bilateral, indeterminate stage |
H40.51X0 | Glaucoma secondary to other eye disorders, right eye, stage unspecified |
H40.51X1 | Glaucoma secondary to other eye disorders, right eye, mild stage |
H40.51X2 | Glaucoma secondary to other eye disorders, right eye, moderate stage |
H40.51X3 | Glaucoma secondary to other eye disorders, right eye, severe stage |
H40.51X4 | Glaucoma secondary to other eye disorders, right eye, indeterminate stage |
H40.52X0 | Glaucoma secondary to other eye disorders, left eye, stage unspecified |
H40.52X1 | Glaucoma secondary to other eye disorders, left eye, mild stage |
H40.52X2 | Glaucoma secondary to other eye disorders, left eye, moderate stage |
H40.52X3 | Glaucoma secondary to other eye disorders, left eye, severe stage |
H40.52X4 | Glaucoma secondary to other eye disorders, left eye, indeterminate stage |
H40.53X0 | Glaucoma secondary to other eye disorders, bilateral, stage unspecified |
H40.53X1 | Glaucoma secondary to other eye disorders, bilateral, mild stage |
H40.53X2 | Glaucoma secondary to other eye disorders, bilateral, moderate stage |
H40.53X3 | Glaucoma secondary to other eye disorders, bilateral, severe stage |
H40.53X4 | Glaucoma secondary to other eye disorders, bilateral, indeterminate stage |
H40.61X0 | Glaucoma secondary to drugs, right eye, stage unspecified |
H40.61X1 | Glaucoma secondary to drugs, right eye, mild stage |
H40.61X2 | Glaucoma secondary to drugs, right eye, moderate stage |
H40.61X3 | Glaucoma secondary to drugs, right eye, severe stage |
H40.61X4 | Glaucoma secondary to drugs, right eye, indeterminate stage |
H40.62X0 | Glaucoma secondary to drugs, left eye, stage unspecified |
H40.62X1 | Glaucoma secondary to drugs, left eye, mild stage |
H40.62X2 | Glaucoma secondary to drugs, left eye, moderate stage |
H40.62X3 | Glaucoma secondary to drugs, left eye, severe stage |
H40.62X4 | Glaucoma secondary to drugs, left eye, indeterminate stage |
H40.63X0 | Glaucoma secondary to drugs, bilateral, stage unspecified |
H40.63X1 | Glaucoma secondary to drugs, bilateral, mild stage |
H40.63X2 | Glaucoma secondary to drugs, bilateral, moderate stage |
H40.63X3 | Glaucoma secondary to drugs, bilateral, severe stage |
H40.63X4 | Glaucoma secondary to drugs, bilateral, indeterminate stage |
H40.811 | Glaucoma with increased episcleral venous pressure, right eye |
H40.812 | Glaucoma with increased episcleral venous pressure, left eye |
H40.813 | Glaucoma with increased episcleral venous pressure, bilateral |
H40.821 | Hypersecretion glaucoma, right eye |
H40.822 | Hypersecretion glaucoma, left eye |
H40.823 | Hypersecretion glaucoma, bilateral |
H40.831 | Aqueous misdirection, right eye |
H40.832 | Aqueous misdirection, left eye |
H40.833 | Aqueous misdirection, bilateral |
H40.89 | Other specified glaucoma |
H40.9 | Unspecified glaucoma |
H42 | Glaucoma in diseases classified elsewhere |
H43.01 | Vitreous prolapse, right eye |
H43.02 | Vitreous prolapse, left eye |
H43.03 | Vitreous prolapse, bilateral |
H43.11 | Vitreous hemorrhage, right eye |
H43.12 | Vitreous hemorrhage, left eye |
H43.13 | Vitreous hemorrhage, bilateral |
H43.21 | Crystalline deposits in vitreous body, right eye |
H43.22 | Crystalline deposits in vitreous body, left eye |
H43.23 | Crystalline deposits in vitreous body, bilateral |
H43.311 | Vitreous membranes and strands, right eye |
H43.312 | Vitreous membranes and strands, left eye |
H43.313 | Vitreous membranes and strands, bilateral |
H43.391 | Other vitreous opacities, right eye |
H43.392 | Other vitreous opacities, left eye |
H43.393 | Other vitreous opacities, bilateral |
H43.811 | Vitreous degeneration, right eye |
H43.812 | Vitreous degeneration, left eye |
H43.813 | Vitreous degeneration, bilateral |
H43.821 | Vitreomacular adhesion, right eye |
H43.822 | Vitreomacular adhesion, left eye |
H43.823 | Vitreomacular adhesion, bilateral |
H43.89 | Other disorders of vitreous body |
H44.001 | Unspecified purulent endophthalmitis, right eye |
H44.002 | Unspecified purulent endophthalmitis, left eye |
H44.003 | Unspecified purulent endophthalmitis, bilateral |
H44.011 | Panophthalmitis (acute), right eye |
H44.012 | Panophthalmitis (acute), left eye |
H44.013 | Panophthalmitis (acute), bilateral |
H44.021 | Vitreous abscess (chronic), right eye |
H44.022 | Vitreous abscess (chronic), left eye |
H44.023 | Vitreous abscess (chronic), bilateral |
H44.111 | Panuveitis, right eye |
H44.112 | Panuveitis, left eye |
H44.113 | Panuveitis, bilateral |
H44.121 | Parasitic endophthalmitis, unspecified, right eye |
H44.122 | Parasitic endophthalmitis, unspecified, left eye |
H44.123 | Parasitic endophthalmitis, unspecified, bilateral |
H44.131 | Sympathetic uveitis, right eye |
H44.132 | Sympathetic uveitis, left eye |
H44.133 | Sympathetic uveitis, bilateral |
H44.19 | Other endophthalmitis |
H44.21 | Degenerative myopia, right eye |
H44.22 | Degenerative myopia, left eye |
H44.23 | Degenerative myopia, bilateral |
H44.2A1 | Degenerative myopia with choroidal neovascularization, right eye |
H44.2A2 | Degenerative myopia with choroidal neovascularization, left eye |
H44.2A3 | Degenerative myopia with choroidal neovascularization, bilateral eye |
H44.2A9 | Degenerative myopia with choroidal neovascularization, unspecified eye |
H44.2B1 | Degenerative myopia with macular hole, right eye |
H44.2B2 | Degenerative myopia with macular hole, left eye |
H44.2B3 | Degenerative myopia with macular hole, bilateral eye |
H44.2B9 | Degenerative myopia with macular hole, unspecified eye |
H44.2C1 | Degenerative myopia with retinal detachment, right eye |
H44.2C2 | Degenerative myopia with retinal detachment, left eye |
H44.2C3 | Degenerative myopia with retinal detachment, bilateral eye |
H44.2C9 | Degenerative myopia with retinal detachment, unspecified eye |
H44.2D1 | Degenerative myopia with foveoschisis, right eye |
H44.2D2 | Degenerative myopia with foveoschisis, left eye |
H44.2D3 | Degenerative myopia with foveoschisis, bilateral eye |
H44.2D9 | Degenerative myopia with foveoschisis, unspecified eye |
H44.2E1 | Degenerative myopia with other maculopathy, right eye |
H44.2E2 | Degenerative myopia with other maculopathy, left eye |
H44.2E3 | Degenerative myopia with other maculopathy, bilateral eye |
H44.2E9 | Degenerative myopia with other maculopathy, unspecified eye |
H44.311 | Chalcosis, right eye |
H44.312 | Chalcosis, left eye |
H44.313 | Chalcosis, bilateral |
H44.321 | Siderosis of eye, right eye |
H44.322 | Siderosis of eye, left eye |
H44.323 | Siderosis of eye, bilateral |
H44.391 | Other degenerative disorders of globe, right eye |
H44.392 | Other degenerative disorders of globe, left eye |
H44.393 | Other degenerative disorders of globe, bilateral |
H44.411 | Flat anterior chamber hypotony of right eye |
H44.412 | Flat anterior chamber hypotony of left eye |
H44.413 | Flat anterior chamber hypotony of eye, bilateral |
H44.421 | Hypotony of right eye due to ocular fistula |
H44.422 | Hypotony of left eye due to ocular fistula |
H44.423 | Hypotony of eye due to ocular fistula, bilateral |
H44.431 | Hypotony of eye due to other ocular disorders, right eye |
H44.432 | Hypotony of eye due to other ocular disorders, left eye |
H44.433 | Hypotony of eye due to other ocular disorders, bilateral |
H44.441 | Primary hypotony of right eye |
H44.442 | Primary hypotony of left eye |
H44.443 | Primary hypotony of eye, bilateral |
H44.511 | Absolute glaucoma, right eye |
H44.512 | Absolute glaucoma, left eye |
H44.513 | Absolute glaucoma, bilateral |
H44.521 | Atrophy of globe, right eye |
H44.522 | Atrophy of globe, left eye |
H44.523 | Atrophy of globe, bilateral |
H44.531 | Leucocoria, right eye |
H44.532 | Leucocoria, left eye |
H44.533 | Leucocoria, bilateral |
H44.601 | Unspecified retained (old) intraocular foreign body, magnetic, right eye |
H44.602 | Unspecified retained (old) intraocular foreign body, magnetic, left eye |
H44.603 | Unspecified retained (old) intraocular foreign body, magnetic, bilateral |
H44.611 | Retained (old) magnetic foreign body in anterior chamber, right eye |
H44.612 | Retained (old) magnetic foreign body in anterior chamber, left eye |
H44.613 | Retained (old) magnetic foreign body in anterior chamber, bilateral |
H44.621 | Retained (old) magnetic foreign body in iris or ciliary body, right eye |
H44.622 | Retained (old) magnetic foreign body in iris or ciliary body, left eye |
H44.623 | Retained (old) magnetic foreign body in iris or ciliary body, bilateral |
H44.631 | Retained (old) magnetic foreign body in lens, right eye |
H44.632 | Retained (old) magnetic foreign body in lens, left eye |
H44.633 | Retained (old) magnetic foreign body in lens, bilateral |
H44.641 | Retained (old) magnetic foreign body in posterior wall of globe, right eye |
H44.642 | Retained (old) magnetic foreign body in posterior wall of globe, left eye |
H44.643 | Retained (old) magnetic foreign body in posterior wall of globe, bilateral |
H44.651 | Retained (old) magnetic foreign body in vitreous body, right eye |
H44.652 | Retained (old) magnetic foreign body in vitreous body, left eye |
H44.653 | Retained (old) magnetic foreign body in vitreous body, bilateral |
H44.691 | Retained (old) intraocular foreign body, magnetic, in other or multiple sites, right eye |
H44.692 | Retained (old) intraocular foreign body, magnetic, in other or multiple sites, left eye |
H44.693 | Retained (old) intraocular foreign body, magnetic, in other or multiple sites, bilateral |
H44.701 | Unspecified retained (old) intraocular foreign body, nonmagnetic, right eye |
H44.702 | Unspecified retained (old) intraocular foreign body, nonmagnetic, left eye |
H44.703 | Unspecified retained (old) intraocular foreign body, nonmagnetic, bilateral |
H44.711 | Retained (nonmagnetic) (old) foreign body in anterior chamber, right eye |
H44.712 | Retained (nonmagnetic) (old) foreign body in anterior chamber, left eye |
H44.713 | Retained (nonmagnetic) (old) foreign body in anterior chamber, bilateral |
H44.721 | Retained (nonmagnetic) (old) foreign body in iris or ciliary body, right eye |
H44.722 | Retained (nonmagnetic) (old) foreign body in iris or ciliary body, left eye |
H44.723 | Retained (nonmagnetic) (old) foreign body in iris or ciliary body, bilateral |
H44.731 | Retained (nonmagnetic) (old) foreign body in lens, right eye |
H44.732 | Retained (nonmagnetic) (old) foreign body in lens, left eye |
H44.733 | Retained (nonmagnetic) (old) foreign body in lens, bilateral |
H44.741 | Retained (nonmagnetic) (old) foreign body in posterior wall of globe, right eye |
H44.742 | Retained (nonmagnetic) (old) foreign body in posterior wall of globe, left eye |
H44.743 | Retained (nonmagnetic) (old) foreign body in posterior wall of globe, bilateral |
H44.751 | Retained (nonmagnetic) (old) foreign body in vitreous body, right eye |
H44.752 | Retained (nonmagnetic) (old) foreign body in vitreous body, left eye |
H44.753 | Retained (nonmagnetic) (old) foreign body in vitreous body, bilateral |
H44.791 | Retained (old) intraocular foreign body, nonmagnetic, in other or multiple sites, right eye |
H44.792 | Retained (old) intraocular foreign body, nonmagnetic, in other or multiple sites, left eye |
H44.793 | Retained (old) intraocular foreign body, nonmagnetic, in other or multiple sites, bilateral |
H44.811 | Hemophthalmos, right eye |
H44.812 | Hemophthalmos, left eye |
H44.813 | Hemophthalmos, bilateral |
H44.821 | Luxation of globe, right eye |
H44.822 | Luxation of globe, left eye |
H44.823 | Luxation of globe, bilateral |
H44.89 | Other disorders of globe |
H44.9 | Unspecified disorder of globe |
H46.01 | Optic papillitis, right eye |
H46.02 | Optic papillitis, left eye |
H46.03 | Optic papillitis, bilateral |
H46.11 | Retrobulbar neuritis, right eye |
H46.12 | Retrobulbar neuritis, left eye |
H46.13 | Retrobulbar neuritis, bilateral |
H46.2 | Nutritional optic neuropathy |
H46.3 | Toxic optic neuropathy |
H46.8 | Other optic neuritis |
H47.011 | Ischemic optic neuropathy, right eye |
H47.012 | Ischemic optic neuropathy, left eye |
H47.013 | Ischemic optic neuropathy, bilateral |
H47.021 | Hemorrhage in optic nerve sheath, right eye |
H47.022 | Hemorrhage in optic nerve sheath, left eye |
H47.023 | Hemorrhage in optic nerve sheath, bilateral |
H47.091 | Other disorders of optic nerve, not elsewhere classified, right eye |
H47.092 | Other disorders of optic nerve, not elsewhere classified, left eye |
H47.093 | Other disorders of optic nerve, not elsewhere classified, bilateral |
H47.11 | Papilledema associated with increased intracranial pressure |
H47.12 | Papilledema associated with decreased ocular pressure |
H47.13 | Papilledema associated with retinal disorder |
H47.141 | Foster-Kennedy syndrome, right eye |
H47.142 | Foster-Kennedy syndrome, left eye |
H47.143 | Foster-Kennedy syndrome, bilateral |
H47.211 | Primary optic atrophy, right eye |
H47.212 | Primary optic atrophy, left eye |
H47.213 | Primary optic atrophy, bilateral |
H47.22 | Hereditary optic atrophy |
H47.231 | Glaucomatous optic atrophy, right eye |
H47.232 | Glaucomatous optic atrophy, left eye |
H47.233 | Glaucomatous optic atrophy, bilateral |
H47.291 | Other optic atrophy, right eye |
H47.292 | Other optic atrophy, left eye |
H47.293 | Other optic atrophy, bilateral |
H47.311 | Coloboma of optic disc, right eye |
H47.312 | Coloboma of optic disc, left eye |
H47.313 | Coloboma of optic disc, bilateral |
H47.321 | Drusen of optic disc, right eye |
H47.322 | Drusen of optic disc, left eye |
H47.323 | Drusen of optic disc, bilateral |
H47.331 | Pseudopapilledema of optic disc, right eye |
H47.332 | Pseudopapilledema of optic disc, left eye |
H47.333 | Pseudopapilledema of optic disc, bilateral |
H47.391 | Other disorders of optic disc, right eye |
H47.392 | Other disorders of optic disc, left eye |
H47.393 | Other disorders of optic disc, bilateral |
H47.41 | Disorders of optic chiasm in (due to) inflammatory disorders |
H47.42 | Disorders of optic chiasm in (due to) neoplasm |
H47.43 | Disorders of optic chiasm in (due to) vascular disorders |
H47.49 | Disorders of optic chiasm in (due to) other disorders |
H53.121 | Transient visual loss, right eye |
H53.122 | Transient visual loss, left eye |
H53.123 | Transient visual loss, bilateral |
H53.131 | Sudden visual loss, right eye |
H53.132 | Sudden visual loss, left eye |
H53.133 | Sudden visual loss, bilateral |
H53.141 | Visual discomfort, right eye |
H53.142 | Visual discomfort, left eye |
H53.143 | Visual discomfort, bilateral |
H53.15 | Visual distortions of shape and size |
H53.16 | Psychophysical visual disturbances |
H53.19 | Other subjective visual disturbances |
H53.411 | Scotoma involving central area, right eye |
H53.412 | Scotoma involving central area, left eye |
H53.413 | Scotoma involving central area, bilateral |
H53.421 | Scotoma of blind spot area, right eye |
H53.422 | Scotoma of blind spot area, left eye |
H53.423 | Scotoma of blind spot area, bilateral |
H53.431 | Sector or arcuate defects, right eye |
H53.432 | Sector or arcuate defects, left eye |
H53.433 | Sector or arcuate defects, bilateral |
H53.451 | Other localized visual field defect, right eye |
H53.452 | Other localized visual field defect, left eye |
H53.453 | Other localized visual field defect, bilateral |
H53.461 | Homonymous bilateral field defects, right side |
H53.462 | Homonymous bilateral field defects, left side |
H53.47 | Heteronymous bilateral field defects |
H53.481 | Generalized contraction of visual field, right eye |
H53.482 | Generalized contraction of visual field, left eye |
H53.483 | Generalized contraction of visual field, bilateral |
H53.50 | Unspecified color vision deficiencies |
H53.61 | Abnormal dark adaptation curve |
H53.62 | Acquired night blindness |
H53.63 | Congenital night blindness |
H53.69 | Other night blindness |
H53.71 | Glare sensitivity |
H53.72 | Impaired contrast sensitivity |
H53.8 | Other visual disturbances |
H53.9 | Unspecified visual disturbance |
H54.0X33 | Blindness right eye category 3, blindness left eye category 3 |
H54.0X34 | Blindness right eye category 3, blindness left eye category 4 |
H54.0X35 | Blindness right eye category 3, blindness left eye category 5 |
H54.0X43 | Blindness right eye category 4, blindness left eye category 3 |
H54.0X44 | Blindness right eye category 4, blindness left eye category 4 |
H54.0X45 | Blindness right eye category 4, blindness left eye category 5 |
H54.0X53 | Blindness right eye category 5, blindness left eye category 3 |
H54.0X54 | Blindness right eye category 5, blindness left eye category 4 |
H54.0X55 | Blindness right eye category 5, blindness left eye category 5 |
H54.1131 | Blindness right eye category 3, low vision left eye category 1 |
H54.1132 | Blindness right eye category 3, low vision left eye category 2 |
H54.1141 | Blindness right eye category 4, low vision left eye category 1 |
H54.1142 | Blindness right eye category 4, low vision left eye category 2 |
H54.1151 | Blindness right eye category 5, low vision left eye category 1 |
H54.1152 | Blindness right eye category 5, low vision left eye category 2 |
H54.1213 | Low vision right eye category 1, blindness left eye category 3 |
H54.1214 | Low vision right eye category 1, blindness left eye category 4 |
H54.1215 | Low vision right eye category 1, blindness left eye category 5 |
H54.1223 | Low vision right eye category 2, blindness left eye category 3 |
H54.1224 | Low vision right eye category 2, blindness left eye category 4 |
H54.1225 | Low vision right eye category 2, blindness left eye category 5 |
H54.2X11 | Low vision right eye category 1, low vision left eye category 1 |
H54.2X12 | Low vision right eye category 1, low vision left eye category 2 |
H54.2X21 | Low vision right eye category 2, low vision left eye category 1 |
H54.2X22 | Low vision right eye category 2, low vision left eye category 2 |
H54.413A | Blindness right eye category 3, normal vision left eye |
H54.414A | Blindness right eye category 4, normal vision left eye |
H54.415A | Blindness right eye category 5, normal vision left eye |
H54.42A3 | Blindness left eye category 3, normal vision right eye |
H54.42A4 | Blindness left eye category 4, normal vision right eye |
H54.42A5 | Blindness left eye category 5, normal vision right eye |
H54.511A | Low vision right eye category 1, normal vision left eye |
H54.512A | Low vision right eye category 2, normal vision left eye |
H54.52A1 | Low vision left eye category 1, normal vision right eye |
H54.52A2 | Low vision left eye category 2, normal vision right eye |
M05.9 | Rheumatoid arthritis with rheumatoid factor, unspecified |
M06.9 | Rheumatoid arthritis, unspecified |
M08.89 | Other juvenile arthritis, multiple sites |
Q14.0 | Congenital malformation of vitreous humor |
Q14.1 | Congenital malformation of retina |
Q14.2 | Congenital malformation of optic disc |
Q14.3 | Congenital malformation of choroid |
Q14.8 | Other congenital malformations of posterior segment of eye |
Q14.9 | Congenital malformation of posterior segment of eye, unspecified |
Q15.0 | Congenital glaucoma |
Q15.8 | Other specified congenital malformations of eye |
Q15.9 | Congenital malformation of eye, unspecified |
Q85.1 | Tuberous sclerosis |
Q85.8 | Other phakomatoses, not elsewhere classified |
Q87.410 | Marfan's syndrome with aortic dilation |
Q87.418 | Marfan's syndrome with other cardiovascular manifestations |
Q87.42 | Marfan's syndrome with ocular manifestations |
Q87.43 | Marfan's syndrome with skeletal manifestation |
R44.1 | Visual hallucinations |
R48.3 | Visual agnosia |
S05.11XA | Contusion of eyeball and orbital tissues, right eye, initial encounter |
S05.11XD | Contusion of eyeball and orbital tissues, right eye, subsequent encounter |
S05.11XS | Contusion of eyeball and orbital tissues, right eye, sequela |
S05.12XA | Contusion of eyeball and orbital tissues, left eye, initial encounter |
S05.12XD | Contusion of eyeball and orbital tissues, left eye, subsequent encounter |
S05.12XS | Contusion of eyeball and orbital tissues, left eye, sequela |
S05.20XA | Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, initial encounter |
S05.20XD | Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, subsequent encounter |
S05.20XS | Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, sequela |
S05.21XA | Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter |
S05.21XD | Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, subsequent encounter |
S05.21XS | Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, sequela |
S05.22XA | Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, initial encounter |
S05.22XD | Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, subsequent encounter |
S05.22XS | Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, sequela |
S05.31XA | Ocular laceration without prolapse or loss of intraocular tissue, right eye, initial encounter |
S05.31XD | Ocular laceration without prolapse or loss of intraocular tissue, right eye, subsequent encounter |
S05.31XS | Ocular laceration without prolapse or loss of intraocular tissue, right eye, sequela |
S05.32XA | Ocular laceration without prolapse or loss of intraocular tissue, left eye, initial encounter |
S05.32XD | Ocular laceration without prolapse or loss of intraocular tissue, left eye, subsequent encounter |
S05.32XS | Ocular laceration without prolapse or loss of intraocular tissue, left eye, sequela |
S05.41XA | Penetrating wound of orbit with or without foreign body, right eye, initial encounter |
S05.41XD | Penetrating wound of orbit with or without foreign body, right eye, subsequent encounter |
S05.41XS | Penetrating wound of orbit with or without foreign body, right eye, sequela |
S05.42XA | Penetrating wound of orbit with or without foreign body, left eye, initial encounter |
S05.42XD | Penetrating wound of orbit with or without foreign body, left eye, subsequent encounter |
S05.42XS | Penetrating wound of orbit with or without foreign body, left eye, sequela |
S05.51XA | Penetrating wound with foreign body of right eyeball, initial encounter |
S05.51XD | Penetrating wound with foreign body of right eyeball, subsequent encounter |
S05.51XS | Penetrating wound with foreign body of right eyeball, sequela |
S05.52XA | Penetrating wound with foreign body of left eyeball, initial encounter |
S05.61XA | Penetrating wound without foreign body of right eyeball, initial encounter |
S05.61XD | Penetrating wound without foreign body of right eyeball, subsequent encounter |
S05.61XS | Penetrating wound without foreign body of right eyeball, sequela |
S05.62XA | Penetrating wound without foreign body of left eyeball, initial encounter |
S05.62XD | Penetrating wound without foreign body of left eyeball, subsequent encounter |
S05.62XS | Penetrating wound without foreign body of left eyeball, sequela |
S05.8X1A | Other injuries of right eye and orbit, initial encounter |
S05.8X1D | Other injuries of right eye and orbit, subsequent encounter |
S05.8X1S | Other injuries of right eye and orbit, sequela |
S05.8X2A | Other injuries of left eye and orbit, initial encounter |
S05.8X2D | Other injuries of left eye and orbit, subsequent encounter |
S05.8X2S | Other injuries of left eye and orbit, sequela |
T74.02XA | Child neglect or abandonment, confirmed, initial encounter |
T74.02XD | Child neglect or abandonment, confirmed, subsequent encounter |
T74.02XS | Child neglect or abandonment, confirmed, sequela |
T74.12XA | Child physical abuse, confirmed, initial encounter |
T74.12XD | Child physical abuse, confirmed, subsequent encounter |
T74.12XS | Child physical abuse, confirmed, sequela |
T74.22XA | Child sexual abuse, confirmed, initial encounter |
T74.22XD | Child sexual abuse, confirmed, subsequent encounter |
T74.22XS | Child sexual abuse, confirmed, sequela |
T74.32XA | Child psychological abuse, confirmed, initial encounter |
T74.32XD | Child psychological abuse, confirmed, subsequent encounter |
T74.32XS | Child psychological abuse, confirmed, sequela |
T74.4XXA | Shaken infant syndrome, initial encounter |
T74.4XXD | Shaken infant syndrome, subsequent encounter |
T74.4XXS | Shaken infant syndrome, sequela |
T74.92XA | Unspecified child maltreatment, confirmed, initial encounter |
T74.92XD | Unspecified child maltreatment, confirmed, subsequent encounter |
T74.92XS | Unspecified child maltreatment, confirmed, sequela |
T76.02XA | Child neglect or abandonment, suspected, initial encounter |
T76.02XD | Child neglect or abandonment, suspected, subsequent encounter |
T76.02XS | Child neglect or abandonment, suspected, sequela |
T76.12XA | Child physical abuse, suspected, initial encounter |
T76.12XD | Child physical abuse, suspected, subsequent encounter |
T76.12XS | Child physical abuse, suspected, sequela |
T76.22XA | Child sexual abuse, suspected, initial encounter |
T76.22XD | Child sexual abuse, suspected, subsequent encounter |
T76.22XS | Child sexual abuse, suspected, sequela |
T76.32XA | Child psychological abuse, suspected, initial encounter |
T76.32XD | Child psychological abuse, suspected, subsequent encounter |
T76.32XS | Child psychological abuse, suspected, sequela |
T79.1XXA | Fat embolism (traumatic), initial encounter |
T79.1XXD | Fat embolism (traumatic), subsequent encounter |
T79.1XXS | Fat embolism (traumatic), sequela |
Z09 | Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm |
Z79.899 | Other long term (current) drug therapy |
The patient’s medical record must contain documentation that fully supports the medical necessity for extended ophthalmoscopy for each eye, as it is covered by Medicare. This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Retinal drawings must be maintained in the patient’s record.
- There must be a separate detailed sketch, minimal size of 3-4 inches
- All items noted must be identified and labeled
- Drawings in four (4) – six (6) standard colors are preferred. However, non-colored drawings are also acceptable, if clearly labeled.
- Optic nerve abnormalities should be separately drawn
- An extensive scaled drawing must accurately represent normal, abnormal and common findings such as: lattice degeneration, hypertensive vascular changes, proliferative diabetic retinopathy, as well as retinal detachments, holes, tears or tumors
Documentation in the patient’s medical record for a diagnosis of glaucoma (ICD-10-CM codes H40.001-H40.152 Glaucoma) must include all of the following:
- A separate detailed drawing of the optic nerve along with an interpretation that affects the plan of treatment
- Documentation of cupping, disc rim, pallor, and slope
- Documentation of any surrounding pathology around the optic nerve
Documentation specific to the method of examination (e.g., lens, scleral depression, instrument used) should be maintained in the medical record.
The medical record should document whether the pupil was dilated, and which drug was used.
All findings and a plan of action should be documented in notes.
Although routine ophthalmoscopy and biomicroscopy are part of an ophthalmologic examination and are not separately payable, these should still be documented in the patient’s medical record.
Documentation supporting the medical necessity should be legible, maintained in the patient’s record, and must be available to the carrier upon request.
CPT codes 92225 is a unilateral code and must be submitted with a site modifier (LT, RT or -50). A claim without the appropriate modifier (RT, LT or -50) will be returned as incomplete. Each service must be billed with an NOS of 001, even if performed bilaterally and billed with a modifier -50.
An initial ophthalmoscopy (CPT code 92225) and a subsequent ophthalmoscopy (CPT code 92226) will not be reimbursed on the same day for the same eye by the same provider. If an initial ophthalmoscopy (CPT code 92225) and a subsequent ophthalmoscopy (CPT code 92226) are performed on different eyes modifier RT and LT should be reported to indicate that the services were performed on different eyes.
Extended ophthalmoscopy is classified as a professional service. The use of professional or technical component modifiers (-26, TC), with these codes, is not appropriate.
CPT code 92225 is payable with ophthalmological examination codes 92002, 92004, 92012 and 92014.
If extended ophthalmoscopy is performed during a global surgery period, unrelated to the condition for which the surgery was performed (same provider), then the extended ophthalmoscopy should be coded with a modifier -79 attached (in addition to the appropriate site modifier).
The initial extended ophthalmoscopy code (92225) may be billed if the patient has had extended ophthalmoscopy (of the same eye) by the same physician/physician group within the last three (3) years.
Indirect ophthalmoscopy done without a drawing may not be billed separately and is part of a general ophthalmologic exam (92002-92014).
Patients actively being treated with intravitreal injections of medication for exudative AMD (ICD-10-CM code H35.32) may require up to 12 extended ophthalmoscopies per eye, per year.
Conditions coded with other ICD-10-CM codes in the ranges A18.53; A18.54; E08.311-E08.359 Diabetes mellitus due to underlying condition with ophthalmic complications E09.311-E09.359 Drug or chemical induced diabetes mellitus with ophthalmic complications;E10.311-E10.359 Type 1 diabetes mellitus with ophthalmic complications; E11.311-E11.359 Type 2 diabetes mellitus with ophthalmic complications; E13.311-E13.359 Other specified diabetes mellitus with ophthalmic complications; H16.241-H16.249 Ophthalmia nodosa; H20.00-H21.1X1; G45.3 Diseases of the eye and adnexa may require up to six (6) extended ophthalmoscopic examinations per eye, per year.
For ICD-10-CM codes C69.20-C69.42 Malignant neoplasm of eye and adnexa; C79.89-C79.9 Secondary malignant neoplasm of other and unspecified sites; D31.20-D31.32 Benign neoplasm of eye and adnexa up to four (4) extended ophthalmoscopic examinations may be required per eye, per year.
Other conditions usually require no more than two (2) extended ophthalmoscopic examinations per eye, per year.
Extended ophthalmoscopy is a physician service (examination of the eye) commonly occurring during the global post-operative period of ophthalmic surgery. As a physician service, it is included in the aftercare of the patient and is not separately billable.
Services exceeding these parameters will be considered not medically necessary.
A detailed sketch must be included in the medical record and available to Medicare upon request. The sketch attached to this policy may be used.
- The sketch should be a minimum size of 3-4″ in diameter
- All items noted must be identified (i.e., any findings such as drusen must be drawn and labeled)
- Drawings in 4-6 standard colors are preferred. However, non-colored drawings are also acceptable.
Colors and Meanings:
RED: Retinal arteries, retinal hemorrhages, attached retina
BLUE: Retinal veins, detached retina
YELLOW: Chorioretinal exudate, intraretinal exudate, intraretinal edema
GREEN: Opacities in media, vitreous hemorrhage
PURPLE: Flat neovascularization
ORANGE: Elevated neovascularization
BROWN: Retinal pigment epithelium or choroidal pigmentation seen through attached retina; vascular occlusion
BLUE OUTLINE FILLED WITH RED: Full thickness sensory retinal break
BLUE OUTLINE CROSS-HATCHED WITH RED: Partial thickness sensory retinal break
BLACK OUTLINE FILLED WITH BLACK LATTICE PATTERN: Lattice degeneration of attached retina
BLUE OUTLINE FILLED WITH BLUE LATTICE PATTERN: Lattice degeneration of detached retina
BLACK OUTLINE CROSS-HATCHED WITH RED: Paving-stone degeneration of attached retina
BROWN OUTLINE CROSS-HATCHED WITH RED: Paving-stone degeneration seen through detached retina
BLUE LINES (SHORT): Retinal tufts and meriodinal folds
BLACK SCALLOPED LINE OVERLYING ORA SERRATA CIRCLE ON FUNDUS CHART: Ora serrata with adjacent detached retina
GREEN OUTLINE FILLED WITH RED: Red blood in vitreous
These charts contain three concentric circles. Inner circle represents equator, middle circle represents ora serrata, and outer circle represents region of ciliary processes. Band between middle and outer circles is pars plana of ciliary body. Small circle in center of chart represents disc. These draw-ings are done so that quick reference may be made and essential informa-tion can be conveyed to others. In addition, these drawings will be used for reference in future examinations as well as helping to “think out” what is presently being encountered.
Use the optic nerve as a reference point. Systematically examine the quadrants out to their periphery. Special features to observe include optic nerve color, cupping, and margination; vascular caliber, pulsa-tions, tortuosity, aneurysms, and anomalies; hemorrhages, exudates, edema, and neovascularization; areas of retinitis, perivasculitis, and arteriolar or venular obliteration; pigmentary changes, hyperplasia, sparsity, and bone-spicule formation; tumors, schisis, elevation, or detachment; peripheral retinal ab-normalities; and especially a close look at the macular area for holes, cysts, edema, or degeneration. Hemiretinal differences have been revealed through the examination of large numbers of fundi. Lattice degeneration, retinal breaks, pars plana cysts, dialysis of the young, and senile retinoschisis are more common in the temporal periphery. In the nasal periphery, it is relatively more common to find prominent teeth, meridional folds at the ora, granular tissue, and detachment of the pars plana.