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Supporting Diagnosis

TANYA Posted Thu 15th of October, 2015 03:25:16 AM

I need clarification in regards to supporting diagnosis for the diagnostic testing for OCT 92133/92134, and fundus photos 92250.
I understand the patient needs to have a supporting diagnosis to bill for these testings, but does the condition have to be visually seen on the test in order for it to be valid to bill?
For example, the patient has been diagnosed with a choroidal nevus (224.6/D31.30). If it is not visible on the fundus/ OCT, does that mean we are not able to bill for the fundus/ OCT?
The patient has the supporting diagnosis, it was just not visible on the testing taken. Are we still able to bill for the testing that was performed?

SuperCoder Answered Fri 16th of October, 2015 05:37:32 AM

Thanks for your question.

Yes, we can bill the testing that was performed with signs and symptoms. If the physician prescribing these tests, there should be some signs and symptoms on which basis these tests were ordered. We can bill these procedure with those signs and symptoms whether there is no definitive diagnosis found.

if there is no signs and symptoms, query with your provider

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