Billing and Coding: Ocular Photography - External

External ocular photography is payable when ordered by an authorized provider and medically necessary to document, diagnose, or monitor external ocular conditions, including to track documented changes with comparison to prior images. Claims must include a valid ICD-10-CM code, required documentation (assessment, signed notes, labeled photos, interpretation), and appropriate modifiers (TC, 26) and places of service; noncovered or expected-denial scenarios require ABN handling and specific GA/GX/GY/GZ modifier use per CMS rules. Repeat imaging is not covered without documented change; frequency is condition-dependent and may be reasonable annually for some patients.

"External ocular photography is covered when ordered by an authorized/referring provider to document, diagnose, or monitor an ocular condition and when medical record documentation supports medical ..."