CPT® Code 92137

1. Indications

The procedure of computerized ophthalmic diagnostic imaging using optical coherence tomography (OCT) is indicated for various conditions affecting the retina. The following are the primary indications for performing this imaging:

• Retinal Vascular Disease This includes conditions such as diabetic retinopathy, where the health of the retinal blood vessels is compromised, necessitating detailed imaging to assess damage and monitor progression.
• Macular Edema This condition involves the accumulation of fluid in the macula, leading to vision impairment. OCT helps evaluate the extent of edema and guides treatment decisions.
• Exudative Macular Degeneration In cases of age-related macular degeneration, OCT is utilized to detect choroidal neovascularization, which can lead to significant vision loss if not addressed.
• Ischemia The imaging assists in identifying areas of reduced blood flow within the retina, which is crucial for diagnosing various retinal pathologies.

2. Procedure

The procedure for computerized ophthalmic diagnostic imaging using OCT involves several key steps to ensure accurate and comprehensive assessment of the retina:

• Patient Positioning The patient is seated comfortably in front of the OCT scanning device. They are instructed to fixate on an internal target displayed by the computer, which helps stabilize the eye during imaging.
• Image Acquisition The OCT device performs multiple radial scans of the posterior segment and retina. This process involves taking thousands of scans per second, capturing detailed images of the retinal structures and microvasculature.
• OCT Angiography In addition to standard OCT imaging, OCT angiography is conducted to visualize the retinal and choroidal blood vessels. This is achieved by analyzing the differences in light reflection over time, allowing for the identification of high- and low-flow areas within the retinal vasculature.
• Data Analysis The digitized images obtained from the scans are displayed on a monitor. The computer calculates retinal thickness and other relevant measurements, which are essential for evaluating the health of the retina.
• Interpretation The physician reviews and interprets the digitized images and measurements. The OCT-A images are reformatted and compared to the non-angiographic images to assess the vasculature at various levels of the retina and choroid.
• Report Generation After thorough evaluation, the physician prepares a detailed report summarizing the findings, which is then added to the patient’s medical record for future reference and treatment planning.

3. Post-Procedure

Post-procedure care following computerized ophthalmic diagnostic imaging with OCT is generally minimal due to the noninvasive nature of the technique. Patients may resume their normal activities immediately after the procedure. However, it is essential for the physician to discuss the results with the patient during a follow-up appointment, where the interpreted findings will be reviewed. Any necessary treatment plans or further diagnostic steps will be outlined based on the results obtained from the imaging. Additionally, if prior studies were reviewed and compared, this information may also be discussed to provide a comprehensive understanding of the patient's ocular health over time.