Does 92274 require prior authorization?

No, 92274 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 92274?

Medicare facility rate: $92.19. Non-facility rate: $92.19. Work RVU: 0.59.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.59

Facility

$92.19

Non-Facility

$92.19

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the medical record must be legible and include appropriate patient identification information, such as full name and dates of service.
The record must include the legible signature of the physician or non-physician practitioner responsible for and providing the patient's care.
The submitted medical record must support the use of the selected ICD-10-CM code(s) and the submitted CPT/HCPCS code must accurately describe the service performed.

Coverage for electroretinography (ERG) is determined by Local Coverage Determination (LCD) L37371; ERG is covered only when reasonable and necessary per LCD L37371.
Perform peripheral venous ultrasound to evaluate clinical signs or symptoms suggestive of acute or new-onset deep vein thrombosis (e.g., extremity swelling, tenderness, erythema).
Perform venous ultrasound to investigate DVT as the source of a confirmed pulmonary embolism.
Repeat or perform venous ultrasound for patients with known venous thrombosis who have a clinical change and where documented change in thrombus burden would alter management or therapy.
Perform venous ultrasound to evaluate postthrombotic (postphlebitic) syndrome in patients with symptoms consistent with PTS (e.g., chronic leg pain, heaviness, swelling, itching, or leg ulcers).
Perform venous ultrasound to evaluate suspected valvular incompetence in patients with symptomatic chronic venous insufficiency or symptomatic varicose veins when the result will confirm diagnosis prior to treatment.

L37015 — Visual Electrophysiology Testing

J05

A57599 — Billing and Coding: Visual Electrophysiology Testing

J05

L36831 — Visual Electrophysiology Testing

J06

A57060 — Billing and Coding: Visual Electrophysiology Testing

J06

L37398 — Electroretinography (ERG)

Ask Verity about documentation requirements, denial risks, or coverage in your state.