5 Key Takeaways

• 1

  The new CPT code for optical coherence tomography angiography (OCTA), 92137, will be effective January 1, 2025, but lacks clear implementation guidelines.

• 2

  OCTA is categorized under SCODI with retinal OCT, and its medical necessity must be documented within the treatment plan to ensure proper utilization.

• 3

  OCTA should generally be performed once per month during active treatment, and no more than every two months for stable patients, with clear documentation.

• 4

  According to NCCI, OCTA is bundled with other imaging codes and cannot be unbundled without proper documentation and medical necessity.

• 5

  Common reasons for denials include lack of medical necessity, missing documentation, and improper frequency of OCTA utilization.