Billing and Coding: Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

SCODI (CPT 92133, 92134) and fundus photography (CPT 92250) are generally mutually exclusive; both may be billed only in limited clinical situations where performing both is necessary. When both are reported, modifier 59 must be appended and the medical record must clearly document the distinct clinical necessity, consistent with LCD L34431.

"When distinct clinical circumstances require both SCODI (CPT 92133 or 92134) and fundus photography (CPT 92250) to evaluate or treat the patient, both procedures may be reported together with modif..."

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