Summary & Overview
CPT 92228: Remote Retinal Imaging Interpretation and Report
CPT code 92228 covers remote interpretation and report of retinal imaging obtained at a location other than the interpreting provider’s site. This code matters nationally as telehealth-enabled retinal imaging expands access to specialty ophthalmic interpretation, supports monitoring of chronic retinal diseases, and interfaces with evolving telemedicine and imaging reimbursement policies. It provides a standardized mechanism for billing when image acquisition and interpretation are separated geographically.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service represented by the code, the common sites of service, and which major payers cover or address this service in their policies. The publication also summarizes benchmarking context and policy considerations relevant to remote retinal imaging services, including coding guidance, documentation expectations, and payer variability in coverage and telehealth parity. Practical takeaways include where CPT code 92228 fits within retinal disease management workflows, how it is used to capture interpretation and reporting when images are obtained off-site, and what types of payers commonly recognize or exclude the service.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and specific payer policy details is noted elsewhere in the document.
Billing Code Overview
CPT code 92228 describes remote interpretation and report of retinal imaging obtained from a location other than the reviewing provider’s location. The service involves acquisition of retinal images of one or both eyes at a separate site and subsequent remote interpretation by a qualified provider, with a written report prepared and delivered.
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Service type: Remote diagnostic imaging interpretation and reporting for retinal disease monitoring and diagnosis
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Typical site of service: Imaging performed at an off-site facility or clinic (not the interpreting provider’s location); interpretation performed remotely by the reviewing provider
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of type 2 diabetes presents to a primary care clinic that has onsite retinal photography performed by trained imaging staff. Fundus images of one or both eyes are captured at the clinic location and transmitted electronically to a retina specialist located at a separate facility. The remote retina specialist reviews the digital retinal images, interprets findings for diabetic retinopathy and macular edema, documents a formal report, and provides recommendations for follow-up or referral. Imaging acquisition is performed outside the interpreting provider’s location; the interpreting provider bills for the remote image interpretation and report using 92228 (telehealth-like remote retinal imaging interpretation). Typical workflow steps: image capture by technician, secure image transfer, remote interpretation by ophthalmologist or retina specialist, generation of a written report added to the patient record, and communication of findings to the referring clinician and patient for management decisions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/report and technical imaging was performed by another entity |