Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green)

Medicare covers fluorescein and indocyanine green (ICG) angiography when the medical record documents medical necessity for each eye and, for ICG, one of specific retinal findings (suspicious/ill-defined subretinal neovascular membrane on prior FA, absent membrane on RPE on current FA, or subretinal hemorrhage/hemorrhagic RPE). Both procedures are limited to nine (9) times per eye in any 365-day period; fluorescein within 30 days of ICG will be denied unless coexisting diseases (e.g., AMD or diabetes) are documented. Detailed documentation (signed assessment, test results, retained angiogram images and interpretation), valid ICD-10 coding, appropriate modifiers, and adherence to POS/professional vs technical component billing rules are required for payment.

"Fluorescein angiography is covered when the medical record documents medical necessity for the procedure for each eye, including relevant history, physical exam, and results of pertinent diagnostic..."