Summary & Overview
CPT 92284: Retinal Photoreceptor Function Testing and Dark Adaptation
CPT code 92284 documents a specialized diagnostic eye test that measures retinal photoreceptor function and the eye’s adaptation between light and dark, including rod and cone sensitivity assessments and the rod–cone breakpoint. This code is used when a clinician performs the physiologic testing, interprets the results, and issues a formal report. Nationally, the test is important for diagnosing inherited retinal diseases, assessing toxic or degenerative retinal changes, and guiding management decisions in low-light visual complaints.
Key payers addressed in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for 92284, typical sites of service, and the types of clinical indications that prompt use of the code. The publication outlines benchmarking and billing considerations relevant to payers listed above, highlights common clinical scenarios that generate the test, and summarizes reporting expectations tied to the CPT descriptor.
This summary provides clinicians, billing professionals, and policy analysts with essential context for coding and documentation, plus a roadmap to where the full publication covers reimbursement benchmarks, payer policy variations, and clinical interpretation requirements. Data not available in the input are noted where applicable in the detailed sections.
Billing Code Overview
CPT code 92284 describes a diagnostic test that evaluates how the eyes adjust to changes in light and darkness. The procedure measures the function of retinal photoreceptors and may include assessments such as rod and cone sensitivities or the rod–cone breakpoint. The provider interprets the test results and prepares a written report.
Service Type: Diagnostic retinal photoreceptor function testing
Typical Site of Service: Ophthalmology or optometry clinic, specialized diagnostic testing facility, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult referred to an ophthalmology or neuro-ophthalmology clinic for evaluation of night vision complaints, suspected inherited retinal disease, or unexplained visual field changes. The patient reports difficulty seeing in low-light conditions or progressive peripheral vision loss. Clinical workflow: the patient undergoes a focused history and ophthalmic examination including visual acuity, pupillary assessment, slit-lamp and dilated fundus exam. If rod-cone dysfunction or retinitis pigmentosa is suspected, the provider orders 92284 (dark-adapted threshold testing/electroretinographic dark adaptation assessment). The test is performed in a controlled dark room with standardized stimulus and adaptation protocol; results quantify rod and cone sensitivities and may identify the rod–cone breakpoint. The provider interprets findings, documents comparison to prior tests if available, and generates a formal report in the medical record. Typical sites of service include outpatient ophthalmology clinics, ambulatory surgical centers with diagnostic capability, or specialized vision testing laboratories. Common clinical indications include suspected rod dysfunction, progressive nyctalopia, monitoring inherited retinal dystrophies, medication toxicity surveillance affecting photoreceptors, and pre-treatment baseline evaluation for retinal therapies.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |