Summary & Overview
CPT 2024F: Seven-Field Fundus Photography for Diabetic Retinopathy
CPT code 2024F describes seven-standard-field fundus photography performed by an ophthalmology or optometry provider for a diabetic patient with evidence of diabetic retinopathy, including interpretation and documentation. This code captures a specific diagnostic imaging service used in retinal surveillance and disease staging, which has national relevance as diabetes prevalence and screening needs continue to grow.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for seven-field retinal photography, typical sites of service, and what this code represents for encounter documentation. The publication provides benchmarking and payment context where available, notes common clinical indications and documentation requirements tied to interpretation, and highlights policy updates that affect billing and coverage for diagnostic retinal imaging.
The report is intended for clinical billing staff, ophthalmology and optometry providers, and policy analysts seeking clear guidance on how this service is categorized and reimbursed across major national payers. Data not available in the input will be flagged as such in relevant sections.
Billing Code Overview
CPT code 2024F documents that an ophthalmology or optometry provider captures seven standard-field fundus photographs in a patient with diabetic retinopathy, interprets the images, and records the findings in the patient’s medical record.
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Service type: Diagnostic retinal photography with interpretation for diabetic retinopathy.
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Typical site of service: Eye clinic, ophthalmology or optometry office, or outpatient imaging suite.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old person with known type 2 diabetes mellitus who presents to an ophthalmology clinic for surveillance of diabetic retinopathy. The patient reports no acute visual loss but has had progressive microvascular disease on prior examinations. The ophthalmology or optometry provider performs seven standard‑field stereoscopic fundus photography to document the presence and severity of diabetic retinopathy and macular changes. Images are captured using a fundus camera in a dedicated imaging suite; the provider reviews the images, interprets findings such as microaneurysms, hemorrhages, neovascularization, and macular edema, and documents the interpretation and plan in the medical record. The imaging is typically scheduled as an outpatient clinic procedure in an ophthalmology or optometry office or an ambulatory imaging center and may be performed during a routine diabetic eye exam or as part of retinopathy surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician interpretation separate from the technical component of imaging if technical component billed by facility or camera owner |
TC | Technical component | When reporting only the technical component (camera, technologist) and not the physician interpretation |
59 | Distinct procedural service | When a separately identifiable imaging service is performed on the same day and not typically included in another service |
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day | When a separately documented E/M visit is provided in addition to the imaging service |
52 | Reduced services | When the full imaging protocol is partially completed and a reduced service is billed |
53 | Discontinued procedure | When the imaging procedure is started but stopped due to patient condition or intolerance |
76 | Repeat procedure by same physician | When the provider repeats the same imaging session later the same day for a documented reason |
77 | Repeat procedure by another physician | When a second provider repeats the imaging the same day for clinical reasons |
90 | Reference (outside) laboratory | Rarely used; when interpretation is provided based on images processed by an external facility |
GQ | Telehealth originating site — asynchronous (store and forward) | When images are captured and sent electronically for remote interpretation in a telemedicine workflow |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207W00000X | Ophthalmology | Medical and surgical eye care providers who commonly perform and interpret retinal imaging |
| 152V00000X | Optometry | Optometrists who perform diabetic retinal photography and surveillance |
| 207X00000X | Retina Specialist (Ophthalmology sub-specialty) | Retina specialists interpret complex retinopathy images and manage advanced disease |
| 363L00000X | Clinical Laboratory/Imaging Technician | Technologists who operate fundus cameras and perform image acquisition |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
E11.319 | Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema | Common indication for seven‑field retinal photography to document nonproliferative retinopathy |
E11.321 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema | Imaging identifies macular changes guiding management decisions |
E11.329 | Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema | Surveillance imaging to track microaneurysms and hemorrhages |
E11.351 | Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema | Seven‑field photos document neovascularization and macular involvement for treatment planning |
E11.359 | Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema | Imaging used to guide interventions such as panretinal photocoagulation |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
92250 | Fundus photography with interpretation and report | Often performed as standard fundus imaging; may be used for non‑stereoscopic fundus photos and complementary to seven‑field imaging |
92227 | Remote imaging for detection of retinal disease, unilateral or bilateral, with remote interpretation and report, for retinal screening | Used in telemedicine programs where images are captured and interpreted off‑site; relates to seven‑field photography when performed remotely |
92226 | Remote imaging for detection of retinal disease, unilateral or bilateral, with imaging only, transmission to a reading center | When only images are acquired and transmitted for interpretation by another entity, with interpretation billed separately |
67028 | Intravitreal injection of a pharmacologic agent | May follow imaging when macular edema or other treatable findings are identified requiring intravitreal therapy |
67311 | Injection of vitreous cavity (subsequent) or other retinal procedures — focal laser photocoagulation | Used when focal/grid laser is applied for diabetic macular edema detected on imaging |
67039 | Destruction of localized lesion of retina (e.g., panretinal photocoagulation) | Used when widespread proliferative retinopathy identified on imaging necessitates panretinal photocoagulation |