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Fluorescein angiography and indocyanine-green angiography are diagnostic imaging techniques used to visualize the blood vessels in the retina and choroid, respectively. Fluorescein angiography involves the injection of fluorescein dye into the bloodstream, which highlights the retinal blood vessels, allowing for the assessment of various retinal disorders. This technique is particularly useful in diagnosing conditions such as diabetic retinopathy, retinal vein occlusion, and other vascular abnormalities. On the other hand, indocyanine-green angiography utilizes indocyanine green dye, which fluoresces in the infrared spectrum, enabling the evaluation of the retina and choroid. This method is beneficial for detecting diseases like macular degeneration, abnormal vessel growth, macular edema, and retinal detachment, as it can penetrate through pigmentation and fluid in the eye. Prior to both procedures, mydriatic drops are administered to dilate the pupil, facilitating better visualization of the fundus. Following dilation, fundal photographs are captured before the dye infusion. A bolus of fluorescein or indocyanine green is injected into a peripheral vein, typically in the arm, and a series of photographs or video images are taken as the dye circulates through the blood vessels. The resulting images are analyzed by a 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. CPT® Code 92242 is specifically reported when both fluorescein angiography and indocyanine-green angiography are conducted during the same patient encounter, ensuring a thorough evaluation of the ocular structures involved.
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Fluorescein angiography and indocyanine-green angiography are indicated for various retinal and choroidal conditions. The following are the specific indications for performing these procedures:
The procedure for fluorescein angiography and indocyanine-green angiography involves several key steps that ensure accurate imaging and assessment of the retina and choroid. The following outlines the procedural steps:
After the completion of fluorescein angiography and indocyanine-green angiography, patients may experience some temporary side effects, such as yellow discoloration of the skin and urine due to the fluorescein dye. It is important for patients to be informed about these effects, which typically resolve within a few hours. Additionally, patients should be monitored for any allergic reactions to the dye, although such reactions are rare. Follow-up care may include scheduling additional appointments for further evaluation or treatment based on the findings from the angiography. Patients are advised to avoid driving immediately after the procedure due to potential visual disturbances caused by the mydriatic drops used for pupil dilation. Overall, the post-procedure care focuses on ensuring patient safety and addressing any immediate concerns following the imaging procedures.
| Short Descr | FLUORESCEIN&ICG ANGIOGRAPHY | Medium Descr | FLUORESCEIN&ICG ANGRPH MULTIFRAME IMG I&R UNI/BI | Long Descr | Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter 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) | I4B - Imaging/procedure - other | MUE | 1 |
| 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. | 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 | 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). | GW | Service not related to the hospice patient's terminal condition | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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) | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | JZ | Zero drug amount discarded/not administered to any patient | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services |
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| 2024-01-01 | Changed | Short and Medium Descriptions changed. |
| 2017-01-01 | Added | Added |
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