Summary & Overview

CPT 92287: Iris Vascular Imaging for Neovascularization

CPT code 92287 identifies a diagnostic ophthalmology procedure that evaluates the vasculature of the iris, most commonly to detect neovascularization associated with anterior segment neoplasms or other vascular abnormalities. Nationally, accurate coding for this specialized ocular vascular imaging is important for clinical tracking, care coordination, and appropriate claims processing within ophthalmology and outpatient diagnostic services.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise outline of the clinical context for 92287, common sites of service, and payer coverage considerations. The publication summarizes typical billing modifiers and payer interactions where available and highlights benchmarks and policy elements relevant to processing this ophthalmic diagnostic code.

The content provides clinical context, coding description, and operational points for revenue cycle and clinical teams to understand where 92287 fits within diagnostic eye care workflows. Data not available in the input is identified explicitly where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 92287ophthalmologyiris vasculature imagingneovascularizationdiagnostic imagingoutpatient eye clinicanterior segment

Billing Code Overview

CPT code 92287 is a diagnostic ophthalmology procedure used to detect abnormalities of the vasculature of the iris. The test is most often used to evaluate neovascularization related to neoplasms or other anterior segment disorders of the eye.

Service type: Diagnostic vascular imaging of the anterior segment of the eye
Typical site of service: Ophthalmology clinic or outpatient eye center

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with a history of proliferative diabetic retinopathy is referred to an ophthalmologist for evaluation of new red vascular membranes noted on slit-lamp exam of the iris and elevated intraocular pressure in the affected eye. The clinician schedules 92287 (iris fluorescein angiography) to characterize iris vascular abnormalities and assess for neovascularization of the iris (rubeosis iridis) and anterior segment neoplasms.

The clinical workflow includes: initial history and focused anterior segment exam, measurement of visual acuity and intraocular pressure, pharmacologic dilation if indicated, informed consent focused on fluorescein use and rare systemic reactions, intravascular administration of fluorescein dye, sequential anterior segment photography with a specialized anterior segment camera or slit-lamp mounted imaging system to record dye transit and leakage from iris vasculature, immediate post-procedure monitoring for allergic reaction, and documentation of findings with interpretation and recommendations. Typical sites of service are the ophthalmology clinic, outpatient imaging suite, or ambulatory surgery center when performed alongside other procedures.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the physician’s interpretation of the imaging study separate from the technical component.
`TC`	Technical component	Use when reporting only the imaging equipment, technologist, and supplies portion of the test.
`52`	Reduced services	Use when the test is partially performed or limited in scope relative to full procedure.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to patient condition or adverse event.
`59` Not listed in provided modifiers	Description not applicable	Data not available in the input.
`76` Not listed in provided modifiers	Description not applicable	Data not available in the input.
`78`	Unplanned return to the operating/procedure room	Use when a patient returns to the procedure area for a complication related to the initial procedure (if applicable in an ASC setting).
`79` Not listed in provided modifiers	Description not applicable	Data not available in the input.
`91` Not listed in provided modifiers	Description not applicable	Data not available in the input.
`QK`	Medical direction of two or more CRNAs where the anesthesiologist is the medical director	Use when applicable anesthesia supervision codes are required for procedures performed with monitored anesthesia care.
`QX`	CRNA service with exception	Use when a CRNA performs services without medical direction by an anesthesiologist subject to payer policy.
`QY`	Medical direction of one CRNA by an anesthesiologist	Use when applicable under payer rules for anesthesia services.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services in lieu of physician	Use when these practitioners perform or report the professional component per payer policy.
`TC`	Technical component (duplicate entry in list)	Use when only the technical portion is billed by the performing facility.

Taxonomy Code	Specialty	Notes
`207W00000X`	Ophthalmology	Ophthalmologists most commonly perform interpretation and oversight of `92287`.
`207VP0202X`	Retina/Vitreous Specialist	Retina specialists evaluate neovascularization related to posterior segment ischemia contributing to anterior segment neovascularization.
`363LA2200X`	Registered Diagnostic Medical Sonographer (Not typical)	Data not available in the input.
`163W00000X`	Optometry	Optometrists may perform anterior segment imaging and preliminary interpretation depending on state scope-of-practice and payer rules.
`208D00000X`	Anesthesiology	Included for scenarios requiring monitored anesthesia care for uncooperative patients or combined procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H31.109`	Unspecified chorioretinal inflammation, unspecified eye	May be associated with anterior segment vascular changes prompting evaluation of iris vasculature.
`H36.0`	Diabetic retinopathy	Common cause of retinal ischemia leading to anterior segment neovascularization and indication for `92287`.
`H20.9`	Iridocyclitis, unspecified	Inflammatory conditions of the anterior segment can alter iris vasculature and are evaluated with angiography when atypical vessels are seen.
`C69.9`	Malignant neoplasm of eye, unspecified	Anterior segment neoplasms may produce abnormal iris vasculature; `92287` helps detect neovascular patterns.
`H21.13`	Angle recession of eye	Trauma-related anterior segment vascular changes may be assessed with iris angiography to evaluate secondary neovascularization.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`92235`	Fluorescein angiography, posterior segment; with interpretation and report	Performed when posterior segment retinal angiography is needed along with anterior segment angiography to evaluate retinal ischemia driving iris neovascularization.
`92134`	Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report; optical coherence tomography (OCT) high-resolution	Performed adjunctively to assess macular or optic nerve pathology that may relate to overall ocular vascular disease.
`92002`	Ophthalmological services: medical examination and evaluation, new patient, intermediate office visit	Preceding evaluation often performed to document symptoms and determine appropriateness of `92287`.
`67028`	Intravitreal injection of a pharmacologic agent	May follow `92287` when iris neovascularization requires anti-VEGF therapy as part of the treatment plan.
`66984`	Extracapsular cataract removal with intraocular lens implantation	May be performed in the same episode of care when cataract surgery is planned and anterior segment vascular status influences surgical risk and management.