Billing and Coding: Electroretinography (ERG)

Coverage for electroretinography (ERG) is determined by LCD L37371 and is limited to services that are reasonable and necessary per that LCD. Do not bill Medicare for non-covered ERG services as if covered and use the appropriate modifier when billing non-covered services. Medical records must be complete and legible, include patient identification and provider signature, support the selected ICD-10-CM and CPT/HCPCS codes, and when reporting Z79.899 must document the medication administered and the underlying condition.

"Coverage for electroretinography (ERG) is determined by Local Coverage Determination (LCD) L37371; ERG is covered only when reasonable and necessary per LCD L37371."

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