Summary & Overview
CPT 92286: Anterior Segment Ocular Vascular Examination with Interpretation
CPT code 92286 denotes a diagnostic examination focused on the anterior segment of the eye with identification of vascular abnormalities and a formal interpretation and report. This procedure is used when clinicians evaluate front‑segment ocular vasculature for conditions that may include neoplastic changes or other vascular lesions. Nationally, the code matters because it captures a specialized ophthalmic diagnostic service that supports clinical decision‑making and guides subsequent management, imaging, or referral.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical nature of the service, typical sites of service, and the role the code plays in documenting diagnostic interpretation and reporting. The publication outlines benchmarks and billing considerations relevant to outpatient ophthalmology practices, summarizes common modifiers used with diagnostic ophthalmic procedures, and places the code in clinical context for providers, coding staff, and payers.
The content provides a national perspective on the code’s use, highlighting where it fits within ophthalmic diagnostic workflows and what documentation elements underpin appropriate coding. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 92286 describes a diagnostic ocular procedure in which the provider examines the anterior segment of the eye, identifying vascular abnormalities such as those associated with neoplasia. The clinician interprets imaging or examination data and generates a clinical report of findings.
Service type: Diagnostic anterior segment ocular examination with interpretation and report
Typical site of service: Ophthalmology or optometry clinic, outpatient specialty eye center, or hospital outpatient department
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a history of ocular surface lesions and new-onset conjunctival erythema and vascular irregularity is referred to an ophthalmologist for evaluation. The provider performs an anterior segment angiographic examination to visualize and document abnormal vascular patterns of the conjunctiva and iris, looking for features suggestive of neoplasia, tumor-associated feeder vessels, or atypical neovascularization. The procedure is performed in an outpatient ophthalmology clinic equipped with slit-lamp biomicroscopy and anterior segment imaging capabilities. The clinician administers topical anesthesia as needed, applies fluorescein or indocyanine green dye per protocol, captures sequential anterior segment images to assess vascular filling and leakage, interprets the imaging findings, and generates a formal report with diagnostic impressions and recommendations for follow-up or additional testing. Typical workflow includes pre-procedure verification, informed consent, administration of any necessary topical medications, image acquisition by the physician or trained imaging technician (depending on payer rules and modifier use), physician interpretation and documentation, and billing of the procedure code 92286 with appropriate modifier(s) reflecting the service components and circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician interpretation and report separate from technical imaging equipment costs |