Summary & Overview
CPT 92227: Remote Retinal Imaging with Asynchronous Interpretation
CPT code 92227 covers remote retinal imaging performed at a location separate from the reviewing clinical staff, with clinical staff analyzing the images and preparing a report to assist in diagnosis and monitoring of retinal disease. This code formalizes asynchronous teleophthalmology imaging services and supports expanded retinal screening and follow-up outside traditional ophthalmology exam settings. Nationally, the code matters because it enables documentation and billing for image acquisition at one site and image interpretation at another, facilitating screening programs, primary care partnerships, and remote specialty review.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines what organizations and clinicians need to know about payer coverage patterns and common administrative considerations when billing for remote retinal imaging.
Readers will learn the clinical context for 92227, typical sites of service where imaging is acquired, and the operational role of asynchronous image interpretation. The report provides benchmarks and policy context where available, highlights common modifier usage (list provided separately), and summarizes implications for teleophthalmology workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92227 describes remote imaging of the retina performed at a location different from the reviewing clinical staff, with clinical staff analysis of the images and preparation of a report. The service supports diagnosis and monitoring of retinal disease, including evaluation for diabetic retinopathy and other retinal pathology.
Service type: Remote retinal imaging with asynchronous review and report (teleophthalmology imaging analysis).
Typical site of service: Imaging performed at an outpatient clinic, eye care facility, primary care office, or other location remote from the reviewing clinician; image interpretation and reporting occur at the reviewing clinical staff’s separate location.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of type 2 diabetes and known nonproliferative diabetic retinopathy presents to a primary care-affiliated diabetic retinal screening program located in a community clinic. A trained technician acquires non-mydriatic retinal fundus images of one or both eyes at the clinic site. The captured images are transmitted securely to a remote ophthalmology practice where clinical staff and a reviewing ophthalmologist analyze the images and prepare a formal report. The remote review documents retinal findings (microaneurysms, hemorrhages, macular edema suspicion) and provides recommendations for follow-up or referral for in‑person ophthalmic evaluation. Billing is submitted by the reviewing practice for the telemedicine imaging analysis under 92227 to reflect retinal imaging performed at a different location than the reviewing clinical staff.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only for the interpretation/reporting component provided by the physician or qualified professional separate from image acquisition. |
TC |