Billing and Coding: Electroretinography (ERG)

Electroretinography (ERG) claims must be supported by an appropriate and specific ICD-10-CM diagnosis and meet locally accepted standards of medical necessity; diagnostic test results or the symptoms prompting the test must be documented. All medical records must be legible, include patient identifiers, dates, and the responsible practitioner's signature; non-covered services require the appropriate ABN and non-coverage modifier (-GA, -GX, -GY, -GZ) with Part A MAC automatic-deny behaviors and occurrence code requirements enforced as specified.

"Electroretinography (ERG) is covered when medically necessary and consistent with locally accepted standards of practice and is supported by an appropriate ICD-10-CM diagnosis that best describes t..."

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