Summary & Overview
CPT 92137: Optical Coherence Tomography Angiography of Retina with Interpretation
CPT code 92137 identifies optical coherence tomography angiography (OCTA) of the posterior segment with interpretation and a formal report. This diagnostic imaging code is used in ophthalmology and optometry to visualize retinal and choroidal vascular structures noninvasively, supporting diagnosis and management of retinal vascular disease, macular degeneration, diabetic retinopathy, and other posterior-segment conditions. Nationally, adoption of OCTA has grown as the technology provides vascular detail without dye injection, making CPT code 92137 increasingly relevant for imaging workflows, documentation, and payer adjudication.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise summary of clinical context, common sites of service, and the kinds of benchmarks and policy topics typically addressed for this code — including utilization patterns, coverage considerations, and billing documentation expectations. The publication also outlines typical report components and interpretation elements associated with the service. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92137 describes computerized diagnostic imaging of the retina that includes optical coherence tomography angiography (OCTA) of the posterior segment of the eye. The procedure encompasses image acquisition, interpretation of the imaging data, and preparation of a diagnostic report. The service may be performed on one or both eyes.
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Service type: Diagnostic retinal imaging using OCT angiography with interpretation and report
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Typical site of service: Ophthalmology or optometry clinic; outpatient imaging center
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive vision distortion and suspected neovascular age-related macular degeneration is referred to the retinal specialist. The provider performs a same-day comprehensive retinal evaluation, including obtaining optical coherence tomography angiography images of the posterior segment to visualize retinal and choroidal vasculature, interpreting the imaging, and documenting a diagnostic report. The workflow typically includes patient check-in and visual acuity testing, dilation of the pupils, acquisition of OCTA scans of one or both eyes by certified ophthalmic imaging staff or the provider, review and interpretation of captured images by the interpreting ophthalmologist or optometrist, generation of a formal report with measurement data and comparison to prior studies, and planning of next steps such as intravitreal pharmacologic therapy, monitoring interval, or referral for treatment. Typical site of service is an outpatient ophthalmology or retina clinic within an ambulatory surgical center or hospital outpatient department when performed in conjunction with other procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpretation and report by the physician separate from technical imaging. |
TC |