Billing and Coding: Panretinal (Scatter) Laser Photocoagulation

Medicare covers panretinal (scatter) laser photocoagulation (CPT 67228) under Part B when performed in approved places of service and under Part A when inpatient/outpatient hospital billing requirements are met, provided a valid ICD-10-CM diagnosis is reported. CPT 67228 may be billed only once per 10-day global period per eye, related procedures during the global period are generally included unless they are clearly distinct (e.g., CPTs 67208/67210/67227 with different indications), and required documentation includes the provider assessment, relevant history, test results, signed notes/reports, and appropriate claim fields (UB-04 FLs, referring NPI, ABN data).

"Panretinal (scatter) laser photocoagulation (CPT 67228) is payable under Medicare Part B when performed in office (POS 11), inpatient hospital (POS 21), outpatient hospital (POS 22), emergency room..."