H53.15 — Visual distortions of shape and size
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
- Every page of the record must be legible and include appropriate patient identification information, including complete name and dates of service.
- The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care.
- The submitted medical record must support the use of the selected ICD-10-CM code(s).
Key Coverage Criteria
- CPT code 93355 is used to report transesophageal echocardiography (TEE) performed during transcatheter intracardiac therapies.
- When contrast is used for a complete TEE procedure (probe placement, image acquisition, interpretation and report), bill CPT code 93312 (HCPCS C8925 for OPPS billing).
- For congenital anomalies, use CPT code 93315 (HCPCS C8926 for OPPS billing) for the complete contrast TEE procedure.
- Hospitals should bill echocardiograms without contrast using the applicable Level 1 CPT code descriptors and guidelines.
- Scanning computerized ophthalmic diagnostic imaging (SCODI) is covered when the service meets the medical necessity criteria and is included within Local Coverage Determination L34380.
- Fundus photography is covered when medical necessity is documented in the medical record, including relevant history, exam, diagnostic test results, and retention of the photographs and an interpretation/report.
20 Active Policies
A56916 — Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
J05
A57483 — Billing and Coding: Visual Fields
J05
L34760 — Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
J05
L34615 — Visual Fields
J05
L33567
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.