Sol Posted Tue 28th of December, 2010 21:51:52 PM
What modifier does Medicare require for CPT: 92225
SuperCoder Answered Tue 28th of December, 2010 22:30:06 PM
There are many modifiers with different rules of applicability for the cpt 92225. But, I think you have apprehnsion on certain common modifiers.
In this context, I would like to mention that certain diagnostic tests are billable for each side (Modifier LT and/or RT) and payable at 100 percent of the allowable reimbursement for each side as billed. When applicable, remember that there must be medical necessity for performing the test on each side. CPT 92225 is commonly used in the retina practice, may be billed for each side and paid for at 100 percent of the allowable for each side:
For the remainder of the special diagnostic tests, the test is billed one time and includes testing of both eyes or sides.