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Official Description

Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Indocyanine-green angiography, designated by CPT® Code 92240, is a diagnostic imaging procedure that utilizes indocyanine green dye to visualize the blood vessels in the retina and choroid. This technique is particularly valuable in the assessment of various retinal diseases, including macular degeneration, abnormal vessel growth, macular edema, and retinal detachment. The indocyanine green dye fluoresces in the infrared spectrum, enabling detailed imaging even in the presence of pigmentation, fluid, or blood collections within the retina and choroid. Prior to the procedure, the patient's pupils are dilated using mydriatic drops to facilitate optimal imaging. Fundal photographs are captured before the dye infusion to establish a baseline. Following the dilation, a bolus of indocyanine green is injected into a peripheral vein, typically in the arm. As the dye circulates, rapid sequence or video imaging is employed to capture the flow of the dye through the retinal and choroidal blood vessels. The resulting images are meticulously analyzed by the physician, who identifies any abnormalities present in the retina or choroid. A comprehensive written report detailing the findings is generated, which may pertain to one eye or both eyes. It is important to note that if both fluorescein angiography and indocyanine-green angiography are conducted during the same patient visit, CPT® Code 92242 should be reported in conjunction with this procedure.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The indications for performing indocyanine-green angiography (CPT® Code 92240) include the evaluation of various retinal and choroidal conditions. This procedure is particularly indicated for:

  • Macular Degeneration - A condition that leads to the deterioration of the central portion of the retina, affecting vision.
  • Abnormal Vessel Growth - The presence of new, often abnormal blood vessels that can lead to complications in the retina.
  • Macular Edema - Swelling or thickening of the macula due to fluid accumulation, which can impair vision.
  • Retinal Detachment - A serious condition where the retina separates from the underlying supportive tissue, requiring prompt diagnosis and treatment.

2. Procedure

The procedure for indocyanine-green angiography involves several critical steps to ensure accurate imaging and assessment of the retina and choroid. The following outlines the procedural steps:

  • Pupil Dilation - The first step involves the administration of mydriatic drops to dilate the patient's pupils. This dilation is essential for obtaining clear and comprehensive images of the retina and choroid.
  • Baseline Fundal Photography - Prior to the injection of indocyanine green dye, fundal photographs are taken to establish a baseline for comparison. These images capture the initial state of the retina.
  • Dye Injection - A bolus of indocyanine green dye is injected into a peripheral vein, typically located in the arm. This dye is crucial for highlighting the blood vessels during imaging.
  • Image Acquisition - As the indocyanine green circulates through the bloodstream, rapid sequence or video imaging is performed. This allows for the capture of the dye as it flows through the retinal and choroidal blood vessels, providing real-time visualization of vascular structures.
  • Image Review - After the imaging is completed, the physician reviews the photographs or video images to identify any abnormalities present in the retina or choroid.
  • Report Generation - A written interpretation of the findings is compiled, detailing any identified abnormalities. This report may pertain to one eye or both eyes, depending on the scope of the procedure.

3. Post-Procedure

Post-procedure care for indocyanine-green angiography typically involves monitoring the patient for any immediate adverse reactions to the dye. Patients may experience temporary visual disturbances due to the dilation of the pupils, but these effects generally resolve as the mydriatic drops wear off. It is advisable for patients to have someone accompany them home, as their vision may be affected. Follow-up appointments may be scheduled to discuss the findings of the angiography and to determine any necessary further treatment based on the results.

Short Descr ICG ANGIOGRAPHY I&R UNI/BI
Medium Descr INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI
Long Descr Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 7 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic ophthalmology services apply...
Bilateral Surgery (50) 2 - 150% payment adjustment does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
Type of Service (TOS) Q - Vision Items or Services
Berenson-Eggers TOS (BETOS) P4E - Eye procedure - other
MUE 1
CCS Clinical Classification 220 - Ophthalmologic and otologic diagnosis and treatment
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GW Service not related to the hospice patient's terminal condition
GC This service has been performed in part by a resident under the direction of a teaching physician
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GZ Item or service expected to be denied as not reasonable and necessary
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
2024-01-01 Changed Short Description changed.
2017-01-01 Changed Long, Medium and Short descriptions changed. Guideline added.
2013-01-01 Changed Medium Descriptor changed.
1997-01-01 Added First appearance in code book in 1997.
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