2025 CPT code 92134
Effective Date: N/A Medicine Services and Procedures > Ophthalmology Services and Procedures Feed
Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina.
Modifiers 26 (Professional Component) and TC (Technical Component) are applicable, along with other standard modifiers such as 51 (Multiple Procedures), 79 (Unrelated Procedure), etc.
Medical necessity must be established for the use of SCODI. This is generally based on signs, symptoms, or established diagnoses that require imaging of the retina for proper evaluation and management.
The physician performs the imaging procedure, interprets the results, and prepares a report. This involves using optical coherence tomography (OCT) to scan the posterior chamber of the eye.
In simple words: The doctor uses a special camera to take detailed pictures of the back part of your eye, called the retina. This helps them check for eye diseases. They will then look at the pictures and explain what they see.
This code represents scanning computerized ophthalmic diagnostic imaging (SCODI) of the retina in the posterior segment of the eye. It includes interpretation and report, and can be performed unilaterally or bilaterally. It is important to note that codes 92133 (SCODI of the optic nerve) and 92134 should not be reported together at the same patient encounter. For scanning computerized ophthalmic diagnostic imaging of both the optic nerve and retina, use 92133 or 92134 as appropriate.
Example 1: A patient with diabetic retinopathy requires monitoring of retinal changes. Code 92134 is used for the OCT scan of the retina., A patient presents with sudden vision loss. 92134 is used to assess the retina for abnormalities such as macular degeneration or retinal detachment., A patient with age-related macular degeneration is undergoing treatment. 92134 is used to monitor the response to treatment and disease progression.
Documentation should include the medical necessity for the procedure, laterality (which eye(s) were imaged), quality of the images, a description of any abnormalities found, and how these findings will impact patient management.
- Revenue Code: M5C (SPECIALIST - OPHTHALMOLOGY)
- Modifier TC rule: Modifier TC applies to the technical component of this service.
- Specialties:Ophthalmology
- Place of Service:Office (11), Nursing Facility (32 - for Medicare patients not in a Part A stay), Independent Clinic (49).