SUPERSEDED Local Coverage Determination (LCD)

Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

L34399

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Proposed LCD
Proposed LCDs are works in progress that are available on the Medicare Coverage Database site for public review. Proposed LCDs are not necessarily a reflection of the current policies or practices of the contractor.
Superseded
To see the currently-in-effect version of this document, go to the section.

Document Note

Note History

Contractor Information

LCD Information

Document Information

Source LCD ID
N/A
LCD ID
L34399
Original ICD-9 LCD ID
Not Applicable
LCD Title
Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)
Proposed LCD in Comment Period
N/A
Source Proposed LCD
N/A
Original Effective Date
For services performed on or after 10/01/2015
Revision Effective Date
For services performed on or after 05/25/2023
Revision Ending Date
06/05/2024
Retirement Date
N/A
Notice Period Start Date
N/A
Notice Period End Date
N/A

CPT codes, descriptions, and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

Copyright © 2024, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution, or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

Issue

Issue Description

Annual Review

Issue - Explanation of Change Between Proposed LCD and Final LCD

CMS National Coverage Policy

Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy. NCDs and coverage provisions in interpretive manuals are not subject to the Local Coverage Determination (LCD) Review Process (42 CFR 405.860[b] and 42 CFR 426 [Subpart D]). In addition, an administrative law judge may not review an NCD. See §1869(f)(1)(A)(i) of the Social Security Act.

Unless otherwise specified, italicized text represents quotation from one or more of the following CMS sources:

Title XVIII of the Social Security Act (SSA):

Section 1862(a)(1)(A) excludes expenses incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Section 1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Section 1862(a) (7) excludes routine physical examination unless otherwise covered by statute.

Code of Federal Regulations:

42 CFR Section 410.32 indicates that diagnostic tests may only be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements) who furnishes a consultation or treats a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary's specific medical problem. Tests not ordered by the physician (or other qualified non-physician provider) who is treating the beneficiary are not reasonable and necessary (see Sec. 411.15(k)(1) of this chapter).

CMS Publications:

CMS Publication 100-04, Medicare Claims Manual, chapter 12:

    40.1.A. Global surgery period

Coverage Guidance

Coverage Indications, Limitations, and/or Medical Necessity

Abstract:

Fundus photography
Fundus photography involves the use of a retinal camera to document abnormalities of of the retina and disease processes affecting the eye, in order to follow the progress of such disease. The test must be used in the medical decision making for the patient.

Extended ophthalmoscopy
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.

Indications:

Fundus photography
Fundus photography may be indicated to document abnormalities of disease processes affecting the eye, or to follow the progress of such disease.

In order to document a disease process or follow the progress of a disease, photographs and an interpretation and report of the test may be necessary. Photographs and an interpretation and report of the test may also be necessary to plan treatment for a disease process.

Fundus photography may be used for the diagnosis of conditions such as macular degeneration, retinal neoplasms, choroid disturbances and diabetic retinopathy, glaucoma, multiple sclerosis or other central nervous system anomalies.

Fundus photography may be indicated for examination of the retina in diabetic patients, in whom symptoms of visual disturbances may be present and in whom retinal examination may be unremarkable or normal.

Extended ophthalmoscopy
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:

If the study is performed as a screening service, it is not covered by Medicare.

Fundus photography

  • All tests must include a written interpretation. If an interpretation is not included in the same medical record with the photograph, then both the technical and professional components will be considered not medically necessary.
  • Fundus photography are bilateral services on the Medicare Physician Fee Schedule Data Base. Services performed unilaterally are subject to a reduction in fee.
  • Fundus photography is not a substitute for an annual dilated examination by a qualified professional (e.g., in diabetic patients). Fundus photographs taken by a non-eye professional and sent (transtelephonically, via internet, or by other means) to a qualified professional for interpretation are covered for the monitoring and management of active retinal disease. The interpretation of tests done with remote imaging must be performed by a physician or qualified non-physician practitioner.
  • Remote imaging for detection of retinal disease is considered screening and will be denied as non-covered.
  • Provision of fundus photography, by providers other than opthalmologists or optometrists, as a screening test to facilitate referral to a specialist is contrary to requirements for testing as codified in 42CFR 410.32, and is therefore not covered. Furthermore, the ordering/performance of fundus photography by eye specialists prior to a face-to-face encounter is similarly not covered or reimbursable.

Extended ophthalmoscopy

  • 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 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 Article (A57071), the service is not separately payable and will be considered part of a general ophthalmologic exam or E&M service.
  • Extended ophthalmoscopy 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.

 

Summary of Evidence

N/A

Analysis of Evidence (Rationale for Determination)

N/A

Proposed Process Information

Synopsis of Changes
Changes Fields Changed
N/A
Associated Information
Sources of Information
Bibliography
Open Meetings
Meeting Date Meeting States Meeting Information
N/A
Contractor Advisory Committee (CAC) Meetings
Meeting Date Meeting States Meeting Information
N/A
MAC Meeting Information URLs
N/A
Proposed LCD Posting Date
Comment Period Start Date
Comment Period End Date
Reason for Proposed LCD
Requestor Information
This request was MAC initiated.
Requestor Name Requestor Letter
View Letter
N/A
Contact for Comments on Proposed LCD

Coding Information

Bill Type Codes

Code Description

Please accept the License to see the codes.

N/A

Revenue Codes

Code Description

Please accept the License to see the codes.

N/A

CPT/HCPCS Codes

Please accept the License to see the codes.

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

Group 1 Paragraph:

N/A

Group 1 Codes:

N/A

N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph:

N/A

Group 1 Codes:

N/A

N/A

Additional ICD-10 Information

General Information

Associated Information
N/A
Sources of Information

This bibliography presents those sources that were obtained during the development of this policy. CGS Administrators, LLC. is not responsible for the continuing viability of Web site addresses listed below.

Fundus photography

Bakri SJ, Sculley L, Sing AD. Imaging techniques for uveal melanoma. Int Ophthalmol Clin. 2006;46(1):1-13. Available at
http://gateway.ut.ovid.com.proxy.medlib.iupui.edu/qw2/ovidweb.cgi. Accessed November 15, 2006.

Mayfeild J. Who cares about the quality of diabetes care? Almost everyone! Clinical Diabetes. 1998;16(4). Available at http://journal.diabetes.org/clinicaldiabetes/v16n41998/Mayfield.htm. Accessed July 21, 2006.

National Guideline Clearinghouse. Age-related macular degeneration. Limited revision. www.guideline.gov. Accessed July 21, 2006.

National Guideline Clearinghouse. Care of the patient with diabetes mellitus. 3rd edition. www.guideline.gov. Accessed July 21, 2006.

National Guideline Clearinghouse. Care of the patient with retinal detachment and related peripheral vitreoretinal disease. Available at: www.guideline.gov. Accessed July 21, 2006.

Other carrier policy (Empire Medical Services [effective 06/01/1996] L682). Available at: http://www.cms.hhs.gov/mcd/results.asp?show=all&t=200647152649 . Accessed July 21, 2006.

Other carrier policy (Empire Medical Services [effective 10/01/2005] L3634 R5). Available at: http://www.cms.hhs.gov/mcd/results.asp?show=all&t=200647152649 . Accessed July 21, 2006.

Other carrier policy (First Coast Service Options [effective 10/30/2006] L18148 R1). Available at: http://www.cms.hhs.gov/mcd/results.asp?show=all&t=200647152649 . Accessed December 8, 2006.

Singh RP, Young LH. Diagnostic tests for posterior segment inflammation. Int Ophthalmol Clin. 2006;46(2):195-208. Available at http://gateway.ut.ovid.com.proxy.medlib.iupui.edu/qw2/ovidweb.cgi. Accessed November 15, 2006.

Extended ophthalmoscopy

Carrier Medical Director, BCBS, Kansas.

Comments from American Academy of Ophthalmology.

Comments from New York State Ophthalmology CAC representative.

Comments from New York State Optometric Association.

Comments from practicing ophthalmologists.

Comments from retinal consultants.

Consultants in Optometry (New Jersey).

CPT editorial staff.

Duane's Clinical Ophthalmology, J. B. Lippincott Co.; 1994.

Essentials of Ophthalmology, Editors Bartley and Liesegang, J.B. Lippincott Co.;1992.

Focus panel of invited ophthalmologists/optometrists convened October 11, 2000 in New York.

Guyer DR, Yannuzzi LA, Chang, S, Shields JA, Green WR. Retina vitreous macula, clinical examination of the posterior segment of the eye. W.B. Saunders Company; 1999:21-28.

HCFA Regional Office reimbursement specialist.

Jones WL, Reidy RW. Atlas of the peripheral ocular fundus. Butterworth Publishers; 1985:1-4.

McPhee S,Papadakis M, Tierney L. Current medical diagnosis and treatment. Stanford: Appleton and Lange; 1996.

Newell F. Ophthalmology-principles and concepts. St. Louis: Mosby; 1992.

Other Carrier Policies:
First Coast Service Options, Inc. - Florida – Database # L6030 (12/18/1995)
Trailblazer Health Enterprises, LLC – Texas – Database # L8867 (11/05/1996)

Additional sources used in reconsideration request for September 1, 2009 revision:

Bresnick GH, Mukaamel DB, Dickinson JC, Cole DR. A screening approach to the surveillance of patients with diabetes for the presence of vision-threatening retinopathy. Ophthalmology. 2000;107:19-24.

Hutchinson A, McIntosh A, Peters J, et al. Effectiveness of screening and monitoring tests for diabetic retinopathy – a systemic review. Diabetes Medicine. 2000;17:495-506.

Personal communications, CMS Coverage and Analysis Group, Marcel Salive, MD, Louis Jacques, MD and Ross Brechner, MD.

Williams GA, Scott IU, Haller JA, et al. Single-field fundus photography for diabetic retinopathy screening. Ophthalmology. 2004;111:1055-1062.

Bibliography

N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation Reasons for Change
05/25/2023 R19

R20

Revision Effective: 05/25/2023

Revision Explanation: Annual review, no changes were made.

At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

  • Other (Annual Review)
06/02/2022 R18

R19

Revision Effective: 06/02/2022

Revision Explanation: Annual review, no changes were made.

At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

  • Other (Annual Review)
05/27/2021 R17

R18

Revision Effective: 05/27/2021

Revision Explanation: Annual review, no changes were made.

05/17/2021: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

  • Other (Annual Review)
12/05/2019 R16

R17

Revision Effective: n/a

Revision Explanation: Annual review, no changes made.

5/27/2020: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

  • Other (Annual review, no changes made)
12/05/2019 R15

R16

Revision Effective: 12/05/2019

Revision Explanation: Removed all coding information from the policy and placed into the billing and coding article based on CR 10901.

11/27/2019:At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

  • Provider Education/Guidance
09/26/2019 R14

R15

Revision Effective: 09/26/2019 Revision Explanation: Converted to new policy template that no longer includes coding section based on CR 10901.

09/20/2019:At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

 

  • Revisions Due To Code Removal
10/01/2017 R13
 

 R14

 Revision Effective:N/A

 Revision Explanation: Annual review no changes made.

DATE (05/19/2019): At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

  • Other (Annual Review)
10/01/2017 R12

 

R13

 

Revision Effective:N/A

 

Revision Explanation: Annual review no changes made.

 

 

 

DATE (05/31/2018): At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.

 

  • Other (Annual review)
10/01/2017 R11

Revision#: R12
Revision Effective: 10/01/2017
Revision Explanation: Added the following ICD-10 code to group one for 92225, 92226, 92228, 92250:

 H44.2A1 , H44.2A2 , H44.2A3, H44.2B1, H44.2B2 , H44.2B3 , H44.2C1 , H44.2C2 , H44.2C3 , H44.2D1  , H44.2D2 , H44.2D3 , H44.2E1  , H44.2E2 , H44.2E3

 

 04/23/2018: At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.





 

 

 

 

Revision#: R11
Revision Effective: N/A
Revision Explanation: Annual review no changes made.

  • Reconsideration Request
10/01/2016 R10 Revision#: R10
Revision Effective: 10/01/2016
Revision Explanation: During annual ICD-10 update the following codes were deleted and replacement codes added: E08.321, E08.329, E08.331, E08.339, E08.341, E08.349, E08.351, E08.359, E09.321, E09.329, E09.331, E09.339, E09.341, E09.349, E09.351, E09.359, E10.321, E10.329, E10.331, E10.339, E10.341, E10.349, E10.351, E10.359, E11.321, E11.329, E11.331, E11.339, E11.341, E11.349, E11.351, E11.359, E13.321, E13.329, E13.331, E13.339, E13.341, E13.349, E13.351, E13.359, H34.811-H34.813, H34.831-H34.833, H35.32, H35.32, H40.11X0-H40.11X4. The following codes were added during annual ICD-10 update: E08.3211, E08.3212, E08.3213, E08.3291, E08.3292, E08.3293, E08.3311, E08.3312, E08.3313, E08.3391, E08.3392, E08.3393, E08.3411, E08.3412, E08.3413, E08.3491, E08.3492, E08.3493, E08.3511, E08.3512, E08.3513, E08.3521, E08.3522, E08.3523, E08.3531, E08.3532, E08.3533, E08.3541, E08.3542, E08.3543, E08.3551, E08.3552, E08.3553, E08.3591, E08.3592, E08.3593, E08.37X1, E08.37X2, E08.37X3, E09.3211, E09.3212, E09.3213, E09.3291, E09.3292, e09.3293, E09.3311, E09.3312, e09.3313, E09.3391, E09.3392, E09.3393, E09.3411, E09.3412, E09.3413, E09.3491, E09.3492, E09.3493, E09.3511, E09.3512, E09.3513, E09.3521, E09.3522, E09.3523, E09.3531, E09.3532, E09.3533, E09.3541, E09.3542, E09.3543, E09.3551, E09.3552, E09.3553, E09.3591, e09.3592, E09.3593, E09.37X1, E09.37X2, E09.37X3, E10.3211, E10.3212, E10.3213, E10.3291, E10.3292, E10.3293, E10.3311, E10.3312, E10.3313, E10.3391, E10.3392, E10.3393, E10.3411, E10.3412, E10.3413, E10.3491, E10.3492, E10.3493, E10.3511, E10.3512, e10.3513, E10.3521, E10.3522, E10.3523, E10.3531, E10.3532, E10.3533, E10.3541, E10.3542, E10.3543, E10.3551, E10.3552, E10.3553, E10.3591, E10.3592, E10.3593, E10.37X1, E10.37X2, E10.37X3, E11.3211, e11.3212, E11.3213, E11.3291, E11.3292, E11.3293, E11.3311, E11.3312, E11.3313, E11.3391, E11.3392, E11.3393, E11.3411, E11.3412, E11.3413, E11.3491, E11.3492, E11.3493, E11.3511, e11.3512, E11.3513, E11.3521, E11.3522, E11.3523, E11.3531, E11.3532, E11.3533, E11.3541, E11.3542, E11.3543, E11.3551, E11.3552, E11.3553, E11.3591, E11.3592, E11.3593, E11.37X1, E11.37X2, E11.37X3, E13.3211, E13.3212, E13.3213, E13.3291, E13.3292, E13.3293, E13.3311, E13.3312, E13.3313, E13.3391, E13.3392, E13.3393, E13.3411, E13.3412, e13.3413, E13.3491, E13.3492, E13.3493, E13.3511, E13.3512, E13.3513, E13.3521, E13.3522, E13.3523, E13.3531, E13.3532, E13.3533, E13.3541, E13.3542, E13.3543, E13.3551, E13.3552, E13.3553, E13.3591, e13.3592, E13.3593, E13.37X1, E13.37X2, E13.37X3, H34.8110, H34.8111, H34.8112, H34.8120, H31.8121, H34.8122, H34.8130, H34.8131, H34.8132, H34.8310, H34.8311,H34.8312, H34.8320, H34.8321, H34.8322, H34.8330, H34.8331, H34.8332, H35.3111, H35.3112, H35.3113, H35.3114,H35.3121 ,H35.3122,H35.3123, H35.3124, H35.3131, H35.3132,H35.3133, H35.3134, H35.3211, H35.3212, H35.3213 ,H35.3221, H35.3222, H35.3223, H35.3231, H35.3232,H35.3233,H40.1110,H40.1111, H40.1112, H40.1113, H40.1114,H40.1120,H40.1121, H40.1122, H40.1123, H40.1124, H40.1130,H40.1131, H40.1132, H40.1133, H40.1134
  • Revisions Due To ICD-10-CM Code Changes
01/01/2016 R9 Revision#: R9
Revision Effective: 01/01/2016
Revision Explanation: Added H35.9 to group 1 ICd-10 list
  • Reconsideration Request
01/01/2016 R8 Revision#: R8
Revision Effective: N/A
Revision Explanation: annual review no changes made.
  • Other (Annual Review)
01/01/2016 R7 Revision#: R7
Revision Effective: 01/01/2016
Revision Explanation: Added H59.031-H59.033 to group 1 set of ICd-10 codes.
  • Reconsideration Request
01/01/2016 R6 Revision#: R6
Revision Effective: 01/01/2016
Revision Explanation: Added E10.65, e10.9, E11.65, and E11.9 to group one ICD-10 codes.
  • Reconsideration Request
10/01/2015 R5 Revision#: R5
Revision Effective: 10/01/2015
Revision Explanation: Added ICd-10 codes H40.021, H40.022, and H40.023 to group one.
  • Reconsideration Request
10/01/2015 R4 Revision#: R4
Revision Effective: 10/01/2015
Revision Explanation: Corrected typos found in the ICD-10 for up to extended 6 ophthalmoscopic examinations. Removed h20.051-H20.053, H31.29, H33.199, H40.021-H40.023, and H40.061-H40.063 these codes should not have been included. Added A18.54, H21.551-H21.553, and H33.031-H33.033 as they were left off in error.
  • Typographical Error
10/01/2015 R3 Revision#: R3
Revision Effective: 10/01/2015
Revision Explanation: Accepted revenue code description changes.
  • Other (revenue code)
10/01/2015 R2 Revision#: R2
Revision Effective: 10/01/2015
Revison Explanation: ICD-10 codes for diagnosis that may require up to six ophthalmoscopic examinations left off in error.
  • Reconsideration Request
10/01/2015 R1 Revision#: R1
Revision Effective: 10/01/2014
Revison Explanation: Approved 2014 annual ICD-10 changes.
  • Revisions Due To ICD-10-CM Code Changes
N/A

Associated Documents

Attachments
N/A
Related National Coverage Documents
N/A
Public Versions
Updated On Effective Dates Status
05/31/2024 06/06/2024 - N/A Currently in Effect View
05/19/2023 05/25/2023 - 06/05/2024 Superseded You are here
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