Summary & Overview
CPT 92230: Fluorescein Angiography of Retina with Interpretation
CPT code 92230 represents fluorescein angiography of the retina and/or choroid with interpretation and report, a diagnostic imaging service that uses injectable dye to visualize ocular vasculature. This procedure is commonly used for evaluation of macular disease, retinal vascular conditions, inflammatory retinal or choroidal disease, optic nerve disorders, tumors, and to plan laser treatments. Nationally, 92230 is important for retina specialists and general ophthalmologists because it supports diagnostic decision-making for sight-threatening conditions and documents findings for treatment planning.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and service context, payer coverage considerations and typical site-of-service expectations, and common billing considerations such as service line placement. The publication also summarizes available benchmarks and policy updates where present and highlights clinical contexts in which the study is most frequently used. Data not available in the input will be noted as such.
Billing Code Overview
CPT code 92230 describes diagnostic ocular fluorescein angiography with interpretation and report. The procedure uses an intravascular dye to highlight retinal and choroidal blood vessels for photographic imaging; the provider interprets the captured images and prepares a formal report.
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Service type: Diagnostic ophthalmic imaging with dye injection
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Typical site of service: Outpatient ophthalmology clinic or ambulatory surgical center for retinal imaging and evaluation
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of type 2 diabetes and progressive visual distortion is referred to a retinal specialist for evaluation. The patient reports metamorphopsia and decreased central vision over several weeks. The ophthalmologist performs a fluorescein angiography study (92230) in an outpatient eye clinic to evaluate macular ischemia, neovascularization, or leakage from diabetic retinopathy. The procedure involves intravenous injection of fluorescein dye, serial fundus photography to document retinal and choroidal circulation, interpretation of the angiographic sequences by the provider, and a written report. Typical workflow: pre-procedure consent and assessment, IV access placement by nursing staff, dye injection and timed imaging by photography technologist, image review and interpretation by the retinal specialist, and documentation of findings with recommendations for follow-up imaging or treatment planning (for example, focal/grid laser or intravitreal therapy). Typical sites of service are outpatient ophthalmology clinic, ambulatory surgical center, or hospital outpatient department. The study is indicated for macular diseases, retinal vascular disease, inflammatory retinal or choroidal disease, optic nerve lesions, tumor assessment, and pre-treatment planning for certain laser procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation/report is billed separately from technical imaging. |