Summary & Overview
CPT 92240: Indocyanine Green Angiography of Retinal and Choroidal Vessels
CPT code 92240 represents indocyanine green (ICG) angiography of the retinal and choroidal circulation, including acquisition of photographs, physician interpretation, and a report. The procedure is an important diagnostic tool in ophthalmology for evaluating choroidal neovascularization, vascular abnormalities, ocular tumors, inflammatory conditions, and for pre-procedural planning of laser or surgical therapies. Nationally, ICG angiography informs treatment decisions in retina subspecialty care and is commonly performed in outpatient ophthalmology clinics and ambulatory surgical centers.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 92240 is used, typical settings of service, and how it relates to other posterior-segment imaging modalities. The publication outlines expected service components (dye injection, image capture, interpretation, and reporting), common clinical indications, and where to look for payer-specific coverage policies and coding guidance.
This summary equips administrators, billing staff, and clinicians with a clear understanding of the clinical role of CPT code 92240, the typical care setting, and the primary payers to consider when reviewing coverage and reimbursement policies at a national level.
Billing Code Overview
CPT code 92240 describes diagnostic imaging of the retinal and choroidal vasculature using indocyanine green (ICG) dye with photographic documentation, interpretation, and report. The procedure is used to evaluate the blood vessels and circulation in the posterior segment of the eye and helps identify vascular abnormalities, choroidal neovascularization, tumors, inflammatory disorders, and to plan some laser or surgical interventions.
Service type: Diagnostic ophthalmic imaging with ICG angiography
Typical site of service: Ophthalmology or retina clinic; outpatient ambulatory surgical center for procedures requiring specialized imaging
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Clinical & Coding Specifications
Clinical Context
A 64-year-old patient with a history of age-related macular degeneration presents with new onset central visual distortion and decreased acuity in the right eye. The retinal specialist schedules an indocyanine green angiography study to image the choroidal vasculature and assess for choroidal neovascularization or occult lesions prior to planning treatment. On arrival to the ophthalmology clinic procedure suite, informed consent is confirmed, allergy status reviewed (noting iodine/shellfish allergy is not a contraindication for ICG but latex and prior reactions are queried), intravenous access is established, and baseline vital signs are documented. The technologist prepares the ICG dye and camera system. The provider injects the ICG intravenously, obtains serial fundus photographs using the angiography camera, interprets the dynamic and late-phase findings, documents the interpretation, and generates a formal report in the electronic medical record. Typical sites of service are an outpatient ophthalmology clinic or ambulatory surgical/diagnostic center. This procedure is commonly used when fluorescein angiography is insufficient for imaging deeper choroidal circulation, for evaluation of choroidal tumors, or for pre-procedural planning for laser or photodynamic therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation/report separate from technical imaging if the facility bills the technical component. |
| | Reduced services | Use when the study is partially completed or limited relative to full protocol.