2025 HCPCS code S3000
Diabetic indicator; retinal eye exam, dilated, bilateral.
Medical necessity is established by the diagnosis of diabetes.
The provider dilates the patient's eyes with eye drops to open up the pupil to see the retina. The exam is performed on both eyes. An indicator that the patient suffers from diabetes may be bleeding of the small blood vessels in the eye.
In simple words: This code represents a dilated eye exam to check for diabetic eye disease.
This code covers a bilateral retinal exam. With the eyes dilated, the provider examines the retina in each eye to look for any indication of diabetes.
Example 1: A 50-year-old patient with type 2 diabetes has an annual dilated retinal exam to screen for diabetic retinopathy. The exam is performed using S3000., A patient with newly diagnosed type 1 diabetes has a dilated retinal exam to establish a baseline. S3000 is used for this exam., A patient with gestational diabetes has a dilated retinal exam. S3000 is used for this exam.
Documentation should include the diagnosis of diabetes, the dilation procedure, the findings of the retinal exam, and the interpretation.
** This code represents all components of the procedure, unlike CPT codes that report each component of a diagnostic test separately.
- Payment Status: Non-Medicare
- Specialties:Ophthalmology, Optometry
- Place of Service:Office