CPT® Code 92226

Deleted

1. Indications

Extended ophthalmoscopy is performed for various indications related to severe posterior segment pathology. The following conditions may warrant this detailed examination:

• Retinal Detachment - A condition where the retina separates from the underlying supportive tissue, requiring careful assessment to determine the extent and location of the detachment.
• Melanoma - A type of eye cancer that can affect the choroid or retina, necessitating thorough examination to evaluate the tumor's characteristics and impact on surrounding structures.

2. Procedure

The procedure for extended ophthalmoscopy involves several critical steps to ensure a comprehensive evaluation of the eye's internal structures. The following outlines the procedural steps:

• Step 1: Patient Preparation - The patient is prepared for the examination by explaining the procedure and its purpose. Eyedrops are administered to dilate the pupil, which enhances visibility of the retina and other internal structures.
• Step 2: Initial Examination - The physician begins the examination using an ophthalmoscope, which emits a beam of light through the dilated pupil. This allows for a detailed view of the fundus, including the retina, optic disc, and blood vessels.
• Step 3: Detailed Assessment - The physician conducts a thorough assessment of the back of the eye, looking for signs of pathology such as retinal detachment, holes, tears, and other abnormalities. The use of a slit-lamp microscope may also be incorporated to enhance the examination.
• Step 4: Documentation - As the examination progresses, the physician creates a detailed drawing that documents the findings. This drawing includes standard colors and labels to indicate the extent of any identified issues, such as the location of retinal detachment or lesions.
• Step 5: Interpretation and Reporting - After completing the examination, the physician compiles an interpretation that summarizes the findings, conclusions, and impressions. This report is essential for ongoing patient management and is documented for future reference.

3. Post-Procedure

Following the extended ophthalmoscopy, patients may experience temporary effects from the dilating eyedrops, such as blurred vision or light sensitivity. It is advisable for patients to have someone accompany them home, as their ability to drive may be impaired. The physician will discuss the findings with the patient and outline any necessary follow-up care or additional evaluations based on the results of the examination. Continuous monitoring may be required for conditions such as retinal detachment or melanoma, and the physician will provide guidance on the appropriate next steps in management.