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PCPs & CPT Cat II codes for documented Eye Care

Hello Coders,

Can a primary care physician, i.e., family practice, submit the following CPT Cat II codes to close HEDIS gaps in care if they receive an eye exam report for their diabetic patients (from an eye care professional), review the report and place it in the patients’ medical record?

2022F: Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed
2024F: 7 standard field stereoscopic photos with interpretation by an ophthalmologist or optometrist documented and reviewed
2026F: Eye imaging validated to match diagnosis from 7 standard field stereoscopic photo results documented and reviewed
3072F: Low risk for retinopathy (no evidence of retinopathy in the prior year)

Thanks for reviewing this!

Yvette Peak

Medical Billing and Coding Forum

Conflict of PCPs

Walk-in clinic, with tax ID of regular provider such as PCP.
Not urgent care clinic.
Doesn’t offer PCP services.
If patient has HMO insurance, should they be turned away since they can’t have two PCPs and their PCP’s name should be on the card. Or they can be seen and clinic would be considered as an out of network and patient will be fully responsible for the cost?
Any ideas?

Medical Billing and Coding Forum