Extended ophthalmoscopy is the inspection of the interior of the eye
with the pupil dilated. This inspection is fundamental to diagnosis and permits visualization of the optic disk, arteries, veins, retina, choroid, and media and is directed toward the condition of the vessels, the color of the tissue and the character of the optic nerve. The three methods
of viewing the ocular fundus include direct ophthalmoscopy, by which
a magnification of about 15X is obtained; indirect ophthalmoscopy, by which a larger field is obtained, but with magnification of two to three
X; and biomicroscopy combined with a lens to neutralize corneal refracting power.

CPT Codes
92225    Ophthalmoscopy, extended, with retinal drawing (e.g., for
              retinal detachment, melanoma), with medical diagnostic
              evaluation; initial

92226    Ophthalmoscopy, extended, with retinal drawing (e.g., for
              retinal detachment, melanoma), with medical diagnostic
              evaluation; subsequent

ICD-9 Codes That Support Medical Necessity
115.92               Ocular histoplasmosis
130.2                 Chorioretinitis due to toxoplasmosis
190.5                  Malignant neoplasm of retina
190.6                  Malignant neoplasm of choroid
224.6                  Benign neoplasm of choroid
225.1                  Benign neoplasm of cranial nerves
360.00-360.04    Purulent endophthalmitis
360.11                Sympathetic uveitis
360.12                Panuveitis
360.13                Parasitic endophthalmitis NOS
360.19                Phacoanaphylactic endophthalmitis
360.21                Progressive high (degenerative) myopia
360.23                Siderosis
360.24                Chalcosis
360.50                Foreign body, magnetic, intraocular, unspecified
360.52                Foreign body, magnetic, in iris or ciliary body
360.54                Foreign body, magnetic, in vitreous
360.60                Foreign body, intraocular, unspecified
360.64                Foreign body in vitreous
360.65                Foreign body in posterior wall
361.00-361.07    Retinal detachment with retinal defect
361.10-361.19    Retinoschisis and retinal cysts
361.2                  Serous retinal detachment
361.30-361.33    Retinal defects without detachment
361.81                Traction detachment of retina
362.01-362.02    Diabetic retinopathy
362.10-362.18    Other background retinopathy and retinal changes
362.21-362.29    Other proliferative retinopathy
362.30-362.37    Retinal vascular occlusion
362.40-362.43    Separation of retinal layers
362.50-362.57    Degeneration of macula and posterior pole
362.60-362.66    Peripheral retinal degenerations
362.70-362.77    Hereditary retinal dystrophies
362.81                Retinal hemorrhage
362.82                Retinal exudates and deposits
362.83                Retinal edema
362.84                Retinal ischemia
363.00-363.08    Focal chorioretinitis and focal retinochoroiditis
363.10-363.15    Disseminated chorioretinitis and disseminated
363.20                Chorioretinitis, unspecified
363.21                Pars planitis
363.22                Harada's disease
363.30-363.35    Chorioretinal scars
363.40-363.43    Choriordal degenerations
363.50-363.57    Hereditary choroidal dystrophies
363.61-363.63    Choroidal hemorrhage and rupture
363.70-363.72    Choroidal detachment
364.24                Vogt-Koyanagi syndrome
365.00-365.04    Borderline glaucoma
365.10-365.15    Open-angle glaucoma
365.20-365.24    Primary angle-closing glaucoma
365.31-365.32    Corticosteroid-induced glaucoma
365.41-365.44    Glaucoma associated with congenital anomalies,
                           dystrophies, and systemic syndromes
365.51-365.59    Glaucoma associated with disorders of the lens
365.60-365.65    Glaucoma associated with other ocular disorders
365.81-365.89    Other specified forms of glaucoma
365.9                   Unspecified glaucoma
368.11                 Sudden visual loss
368.12                 Transient visual loss
368.15                 Other visual distortions and entoptic phenomena
376.6                   Retained (old) foreign body following penetrating
                            wound of orbit
377.00                 Papilledema, unspecified
377.10-377.16     Optic atrophy
377.21-377.24     Other disorders of the optic disc
377.30                 Optic neuritis, unspecified
377.33                 Nutritional optic atrophy
377.34                 Toxic optic neuropathy
377.41                 Ischemic optic neuropathy
377.49                 Other (compression of the optic nerve)
379.07                 Posterior scleritis
379.21-379.29     Disorders of vitreous body
379.32                 Subluxation of lens
379.34                 Posterior dislocation of lens
743.51-743.59    Congenital anomalies of posterior segment
759.5                   Tuberous sclerosis
759.6                   Other hamartoses, not elsewhere classified
759.82                 Marfan syndrome

Coding Guidelines
Reimbursement for an ophthalmoscopy; initial (CPT Code 92225)
and an ophthalmoscopy; subsequent (CPT Code 92226) will not be
made on the same day by the same provider.

Routine ophthalmoscopy is part of an ophthalmologic service and is
not reported separately.