Reimbursement for Fundus Photography with RHA™ (Annidis Health Systems)

This monograph describes reimbursement for fundus photography using Annidis’ RHA (Retinal Health Assessment) multispectral digital ophthalmoscope and digital fundus camera.  Fundus photography has been a staple ophthalmic diagnostic test for decades.  It is a useful tool to screen for disease as well as aid in assessing anomalies and diseases of the fundus and optic nerve.

Much of the information in this document is taken from official publications of the Medicare program.  However, the reader is encouraged to check with the local contractor for additional information and instructions.  In the case of other third party payers, we have used the coding concepts contained in CPT and published by the American Medical Association; diagnosis codes are from ICD-9-CM.  Documentation of the test, as well as the reason for it, are the key to reimbursement, so we describe the required elements in detail.  We provide sample vignettes and the allied claims to clarify potential coverage and coding issues.

Since economic analyses are a necessary part of any capital budgeting decision, we incorporated Medicare’s payment rates for the procedure, as well as estimated utilization rates.

 

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Provided Courtesy of Annidis Health Systems Corp.

 

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