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External Ocular Photography (CPB 0734, reviewed 2025-10-27)
Effective date
Not stated in the notice
Identified
Aug 15, 2026
Summary
Aetna covers external ocular photography (CPT 92285) to track and serially compare changes in listed eye conditions when the results may have an impact on management and clinical outcomes. It is not medically necessary only to document that an eye condition exists, and it should not be repeated when the member's condition has not changed. In some cases the service is expected to be medically necessary once yearly, and more often for certain conditions.
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What to do
Action · 6 steps
01Bill CPT 92285 only when the photographs are taken with a special camera to obtain magnified images of lesions, such as the cornea, iris or lids, to follow the member's condition.
02The photography can be done with a slit-lamp-integrated camera, a goniophotography lens or a close-up stereo camera.
03Permanently label every photograph with the member's name and date and note which eye is pictured, because photographs without that identification will be considered not medically necessary and will be denied.
04Keep an interpretation and report specific to the photographs in the member's medical record and available upon request, and keep copies available for review if requested.
05When more photographs are taken to track changes, keep written documentation describing the changes in the medical record, along with an interpretation comparing them to prior photographs when available.
06Report the photography only once per session even if multiple views are taken, and do not repeat it when the member's condition has not changed.
Codes mentioned
92285B00.52B02.33C41.0H02.831H02.834H02.89H05.00H05.20H15.89L12.1Q10.0
Original notice
External Ocular Photography (CPB 0734, reviewed 2025-10-27)
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