Billing and Coding: Electroretinography (ERG)

This billing and coding article provides documentation and billing guidance for Electroretinography under LCD L37398, emphasizing that non-covered services must not be billed as covered and appropriate modifiers must be used. It requires complete, legible medical records with patient identifiers and provider signatures, supports for reported ICD-10-CM codes and accurate CPT/HCPCS procedure coding, and specific documentation when using ICD-10-CM code Z79.899 detailing the medication and underlying condition.

"Do not bill Medicare for services that are not covered by LCD L37398 as if they are covered; when billing for non-covered services use the appropriate modifier."

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