Local Coverage Determination (LCD): Ophthalmic Angiography (Fluorescein and Indocyanine Green) (L34426) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information Contractor Name Contract Type Contract Number Jurisdiction State(s) Palmetto GBA A and B MAC 10111 - MAC A J - J Alabama Palmetto GBA A and B MAC 10211 - MAC A J - J Georgia Palmetto GBA A and B MAC 10311 - MAC A J - J Tennessee Palmetto GBA A and B and HHH MAC 11201 - MAC A J - M South Carolina Palmetto GBA A and B and HHH MAC 11202 - MAC B J - M South Carolina Palmetto GBA A and B and HHH MAC 11301 - MAC A J - M Virginia Palmetto GBA A and B and HHH MAC 11302 - MAC B J - M Virginia Palmetto GBA A and B and HHH MAC 11401 - MAC A J - M West Virginia Palmetto GBA A and B and HHH MAC 11402 - MAC B J - M West Virginia Palmetto GBA A and B and HHH MAC 11501 - MAC A J - M North Carolina Palmetto GBA A and B and HHH MAC 11502 - MAC B J - M North Carolina Back to Top LCD Information Document Information LCD ID L34426 Original ICD-9 LCD ID L31557 LCD Title Ophthalmic Angiography (Fluorescein and Indocyanine Green) Proposed LCD in Comment Period N/A Source Proposed LCD N/A AMA CPT / ADA CDT / AHA NUBC Copyright Statement Original Effective Date For services performed on or after 10/01/2015 Revision Effective Date For services performed on or after 01/29/2018 Revision Ending Date 02/25/2018 Retirement Date N/A Notice Period Start Date 09/08/2016 Notice Period End Date 10/23/2016 Printed on 1/29/2018. Page 1 of 24
CPT only copyright 2002-2018 American Medical Association. All Rights Reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. The Code on Dental Procedures and Nomenclature (Code) is published in Current Dental Terminology (CDT). Copyright American Dental Association. All rights reserved. CDT and CDT-2016 are trademarks of the American Dental Association. UB-04 Manual. OFFICIAL UB-04 DATA SPECIFICATIONS MANUAL, 2014, is copyrighted by American Hospital Association ( AHA ), Chicago, Illinois. No portion of OFFICIAL UB-04 MANUAL may be reproduced, sorted in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior express, written consent of AHA. Health Forum reserves the right to change the copyright notice from time to time upon written notice to Company. CMS National Coverage Policy Title XVIII of the Social Security Act, 1862 (a)(1)(a) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Title XVIII of the Social Security Act, 1862 (a)(14) defines other than physician services. Title XVIII of the Social Security Act, 1862 (a)(7) excludes routine physical examinations. Title XVIII of the Social Security Act, 1833 (e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim. 42 CFR 410.32 (a) indicates that diagnostic tests may only be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements). 42 CFR 410.74 defines physician assistants' services. 42 CFR 410.75 defines nurse practitioners' services. 42 CFR 410.76 defines clinical nurse specialists' services. CMS Internet-Only Manual, Pub 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 1, 80.2, 80.2.1, 80.3 & 80.3.1 Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Abstract: Fluorescein Fluorescein angiography is used in the diagnosis and treatment of a wide range of ocular disorders. Its visible fluorescence leaking from damaged vessels makes it particularly useful in the diagnosis of retinal vascular disorders and monitoring treatment of conditions amenable to laser photocoagulation. Printed on 1/29/2018. Page 2 of 24
The dye is injected intravenously and serial photographs are taken through the pupil. While morphological characteristics alone may be pathognomonic of certain disease states, the timing of appearance of the dye in the choroid, in the central retinal artery and in the filling (or otherwise) of the quadrants have diagnostic implications. Indocyanine Green Indocyanine green dye is injected intravenously into the patient to highlight the vessels in the retina and the deeper tissue layer of the choroid. Under infrared light, Indocyanine Green fluoresces allowing the choroidal vessels to be visualized through the retinal pigment epithelium or in the presence of retinal or vitreous hemorrhage that would otherwise obscure visualization. Indocyanine green angiography (ICG) is effective in the diagnosis and treatment of ill-defined choroidal neovascularization (e.g., associated with age related macular degeneration (AMD)). It is also useful in the evalution of feeder vessels, choroidal leakages in the late phase, and ruptures of the pigment epithelium. Indications: Fluorescein Fluorescein angiography with interpretation is medically necessary as an adjunct to the diagnosis of chorioretinal vascular abnormalities especially relating to choroid neovascularization, noninfective vasculitis, and age related macular degeneration. It may also be appropriate in evaluating intraocular tumors, visual loss in systemic disease, acute exudative inflammations such as toxoplasmosis and optic disc edema. Medical necessity for such angiography would generally be in the context of a changing clinical picture. Fluorescein angiography may be useful in diabetic retinopathy in identifying ischemia and neovascularization, locating microaneurysms, and defining macular edema. Fluorescein angiography following treatment, for example, of choroidal neovascularization (CNV) is necessary to monitor for recurrence or to detect additional treatable disease. Usually this is performed on the basis of a change in the clinical picture similar to the way it is employed prior to treatment. However, fluorescein angiography may be performed following treatment without clinical change in order to detect occult lesions. This will occur most often in CNV and very rarely in other diseases. Indocyanine Green Indocyanine green angiography (ICG) may be a valuable diagnostic adjunct to fluorescein angiography in the evaluation of the following conditions: Retinal neovascularization Choroid neovascularization Serous detachment of retinal pigment epithelium Hemorrhagic detachment of retinal pigment epithelium Retinal hemorrhage Limitations: Fluorescein Studies performed for screening will be denied by Medicare as not medically necessary. Fluorescein angiography must be performed under the direct supervision (physician present in the office and immediately available) of a physician when done by a non-physician practitioner. If excluded by State law, optometrists may not be reimbursed for fluorescein angiography. Fluorescein angiography of an asymptomatic contralateral without new abnormalities on ophthalmoscopic exam, in patients with unilateral AMD or other disease, will be denied as not medically necessary. Evidence of medical necessity must be documented in the medical record for each. Indocyanine Green Indocyanine green angiography must be performed under the direct supervision (physician present in the office and immediately available) of a physician when done by a non-physician practitioner. Printed on 1/29/2018. Page 3 of 24
If excluded by State law, optometrists may not be reimbursed for ICG angiography. Indocyanine green is formulated with iodine and should not be used on patients who are allergic to iodine. ICG for the evaluation of patients with background diabetic retinopathy is not considered to be a medically necessary service. ICG angiography of an asymptomatic contralateral without new abnormalities on ophthalmoscopic exam, in patients with unilateral AMD or other disease, will be denied as not medically necessary. Evidence of medical necessity must be documented in the medical record for each. Studies performed for screening will be denied by Medicare as not medically necessary. Other Comments: Limitation of liability and refund requirements apply when denials are based on medical necessity. The provider/supplier must notify the beneficiary in writing, prior to rendering the service, if the provider/supplier is aware that the test, item or procedure may not be considered medically necessary by Medicare. The limitation of liability and refund requirements do not apply when the test, item or procedure is statutorily excluded, has no Medicare benefit category or is rendered for screening purposes. For outpatient settings other than CORFs, references to "physicians" throughout this policy include nonphysicians, such as nurse practitioners, clinical nurse specialists and physician assistants. Such non-physician practitioners, with certain exceptions, may certify, order and establish the plan of care as authorized by State law. (See Section CMS National Coverage Policy). Summary of Evidence N/A Analysis of Evidence (Rationale for Determination) N/A Back to Top Coding Information Bill Type Codes: Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims. N/A Revenue Codes: Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the policy, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes. Printed on 1/29/2018. Page 4 of 24
N/A CPT/HCPCS Codes Group 1 Paragraph: CPT Code 92242 can only be billed with a single diagnosis if that diagnosis is a covered diagnosis for both CPT Code 92235 and CPT Code 92240. If the diagnosis to be billed for CPT 92242 is only a covered diagnosis for one of the two procedures encompassed in CPT 92242, the provider also needs to include a second diagnosis code on the claim that is a covered diagnosis for the other of the two studies in order to indicate that there exists a covered diagnosis for both studies included in CPT 92242. Group 1 Codes: FLUORESCEIN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND REPORT, 92235 UNILATERAL OR BILATERAL INDOCYANINE-GREEN ANGIOGRAPHY (INCLUDES MULTIFRAME IMAGING) WITH INTERPRETATION AND 92240 REPORT, UNILATERAL OR BILATERAL FLUORESCEIN ANGIOGRAPHY AND INDOCYANINE-GREEN ANGIOGRAPHY (INCLUDES MULTIFRAME 92242 IMAGING) PERFORMED AT THE SAME PATIENT ENCOUNTER WITH INTERPRETATION AND REPORT, UNILATERAL OR BILATERAL ICD-10 Codes that Support Medical Necessity Group 1 Paragraph: The correct use of an ICD-10 code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this determination. ICD-10 Codes for Fluorescein Angiography (92235) Group 1 Codes: ICD-10 Codes A18.53 Tuberculous chorioretinitis B20 Human immunodeficiency virus [HIV] disease B39.4 Histoplasmosis capsulati, unspecified B39.5 Histoplasmosis duboisii B39.9 Histoplasmosis, unspecified B58.01 Toxoplasma chorioretinitis C69.20 Malignant neoplasm of unspecified retina C69.21 Malignant neoplasm of right retina C69.22 Malignant neoplasm of left retina C69.30 Malignant neoplasm of unspecified choroid C69.31 Malignant neoplasm of right choroid C69.32 Malignant neoplasm of left choroid D18.09 Hemangioma of other sites D31.20 Benign neoplasm of unspecified retina D31.21 Benign neoplasm of right retina D31.22 Benign neoplasm of left retina D31.30 Benign neoplasm of unspecified choroid D31.31 Benign neoplasm of right choroid D31.32 Benign neoplasm of left choroid D57.00 Hb-SS disease with crisis, unspecified D57.01 Hb-SS disease with acute chest syndrome D57.02 Hb-SS disease with splenic sequestration D57.1 Sickle-cell disease without crisis D57.20 Sickle-cell/Hb-C disease without crisis D57.211 Sickle-cell/Hb-C disease with acute chest syndrome D57.212 Sickle-cell/Hb-C disease with splenic sequestration D57.219 Sickle-cell/Hb-C disease with crisis, unspecified D57.80 Other sickle-cell disorders without crisis Printed on 1/29/2018. Page 5 of 24
ICD-10 Codes D57.811 Other sickle-cell disorders with acute chest syndrome D57.812 Other sickle-cell disorders with splenic sequestration D57.819 Other sickle-cell disorders with crisis, unspecified D86.0 Sarcoidosis of lung D86.1 Sarcoidosis of lymph nodes D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes D86.3 Sarcoidosis of skin D86.81 Sarcoid meningitis D86.82 Multiple cranial nerve palsies in sarcoidosis D86.83 Sarcoid iridocyclitis D86.84 Sarcoid pyelonephritis D86.85 Sarcoid myocarditis D86.86 Sarcoid arthropathy D86.87 Sarcoid myositis D86.89 Sarcoidosis of other sites D86.9 Sarcoidosis, unspecified E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right E08.3212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, E08.3291 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right E08.3292 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, E08.3311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right E08.3312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, E08.3391 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right E08.3392 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, E08.3411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right E08.3412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, E08.3491 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right E08.3492 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, E08.3511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right E08.3512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, E08.3521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right Printed on 1/29/2018. Page 6 of 24
ICD-10 Codes E08.3522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, E08.3531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right E08.3532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, E08.3539 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified E08.3541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right E08.3542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, E08.3551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right E08.3552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, E08.3591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right E08.3592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, E08.36 Diabetes mellitus due to underlying condition with diabetic cataract E08.37X1 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right E08.37X2 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left E08.37X3 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, E08.39 Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication E09.3211 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right E09.3212 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left E09.3213 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, E09.3291 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right E09.3292 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left E09.3293 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, E09.3311 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right E09.3312 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left E09.3313 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, E09.3391 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right E09.3392 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left E09.3393 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, E09.3411 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right Printed on 1/29/2018. Page 7 of 24
ICD-10 Codes E09.3412 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left E09.3413 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, E09.3491 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right E09.3492 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left E09.3493 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, E09.3511 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right E09.3512 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left E09.3513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, E09.3521 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right E09.3522 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left E09.3523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, E09.3531 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right E09.3532 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left E09.3533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, E09.3541 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right E09.3542 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left E09.3543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, E09.3551 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right E09.3552 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left E09.3553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, E09.3591 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right E09.3592 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left E09.3593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, E09.36 Drug or chemical induced diabetes mellitus with diabetic cataract E09.37X1 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right E09.37X2 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, left E09.37X3 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, E09.39 Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication E10.3211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right E10.3212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, E10.3291 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right E10.3292 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left E10.3293 Printed on 1/29/2018. Page 8 of 24
ICD-10 Codes Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, E10.3311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right E10.3312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, E10.3391 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right E10.3392 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left E10.3393 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, E10.3411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right E10.3412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, E10.3491 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right E10.3492 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left E10.3493 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, E10.3511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right E10.3512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right E10.3522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, E10.3531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right E10.3532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right E10.3542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, E10.3591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right E10.3592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified E10.37X1 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right E10.37X2 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left E10.37X3 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication E11.3211 Printed on 1/29/2018. Page 9 of 24
ICD-10 Codes Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right E11.3212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, E11.3291 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right E11.3292 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left E11.3293 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, E11.3311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right E11.3312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, E11.3391 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right E11.3392 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left E11.3393 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, E11.3411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, E11.3491 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right E11.3492 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left E11.3493 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, E11.3511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right E11.3512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, E11.3521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right E11.3522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, E11.3531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right E11.3532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, E11.3541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right E11.3542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left Printed on 1/29/2018. Page 10 of 24
ICD-10 Codes E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, E11.36 Type 2 diabetes mellitus with diabetic cataract E11.37X1 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right E11.37X2 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left E11.37X3 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication E13.3211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right E13.3212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, E13.3291 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right E13.3292 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left E13.3293 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, E13.3311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right E13.3312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, E13.3391 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right E13.3392 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left E13.3393 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, E13.3411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right E13.3412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, E13.3491 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right E13.3492 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left E13.3493 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, E13.3511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right E13.3512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, E13.3521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right E13.3522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, E13.3531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right E13.3532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, E13.3541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right Printed on 1/29/2018. Page 11 of 24
ICD-10 Codes E13.3542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, E13.36 Other specified diabetes mellitus with diabetic cataract E13.37X1 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right E13.37X2 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left E13.37X3 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, E13.39 Other specified diabetes mellitus with other diabetic ophthalmic complication E78.00 Pure hypercholesterolemia, unspecified E78.01 Familial hypercholesterolemia E89.820 Postprocedural hematoma of an endocrine system organ or structure following an endocrine system procedure E89.821 Postprocedural hematoma of an endocrine system organ or structure following other procedure E89.822 Postprocedural seroma of an endocrine system organ or structure following an endocrine system procedure E89.823 Postprocedural seroma of an endocrine system organ or structure following other procedure G35 Multiple sclerosis G45.3 Amaurosis fugax G93.2 Benign intracranial hypertension H30.001 Unspecified focal chorioretinal inflammation, right H30.002 Unspecified focal chorioretinal inflammation, left H30.003 Unspecified focal chorioretinal inflammation, H30.011 Focal chorioretinal inflammation, juxtapapillary, right H30.012 Focal chorioretinal inflammation, juxtapapillary, left H30.013 Focal chorioretinal inflammation, juxtapapillary, H30.021 Focal chorioretinal inflammation of posterior pole, right H30.022 Focal chorioretinal inflammation of posterior pole, left H30.023 Focal chorioretinal inflammation of posterior pole, H30.031 Focal chorioretinal inflammation, peripheral, right H30.032 Focal chorioretinal inflammation, peripheral, left H30.033 Focal chorioretinal inflammation, peripheral, H30.041 Focal chorioretinal inflammation, macular or paramacular, right H30.042 Focal chorioretinal inflammation, macular or paramacular, left H30.043 Focal chorioretinal inflammation, macular or paramacular, H30.101 Unspecified disseminated chorioretinal inflammation, right H30.102 Unspecified disseminated chorioretinal inflammation, left H30.103 Unspecified disseminated chorioretinal inflammation, H30.111 Disseminated chorioretinal inflammation of posterior pole, right H30.112 Disseminated chorioretinal inflammation of posterior pole, left H30.113 Disseminated chorioretinal inflammation of posterior pole, H30.121 Disseminated chorioretinal inflammation, peripheral right H30.122 Disseminated chorioretinal inflammation, peripheral, left H30.123 Disseminated chorioretinal inflammation, peripheral, H30.131 Disseminated chorioretinal inflammation, generalized, right H30.132 Disseminated chorioretinal inflammation, generalized, left H30.133 Disseminated chorioretinal inflammation, generalized, Printed on 1/29/2018. Page 12 of 24
ICD-10 Codes H30.141 Acute posterior multifocal placoid pigment epitheliopathy, right H30.142 Acute posterior multifocal placoid pigment epitheliopathy, left H30.143 Acute posterior multifocal placoid pigment epitheliopathy, H30.21 Posterior cyclitis, right H30.22 Posterior cyclitis, left H30.23 Posterior cyclitis, H30.811 Harada's disease, right H30.812 Harada's disease, left H30.813 Harada's disease, H30.891 Other chorioretinal inflammations, right H30.892 Other chorioretinal inflammations, left H30.893 Other chorioretinal inflammations, H30.91 Unspecified chorioretinal inflammation, right H30.92 Unspecified chorioretinal inflammation, left H30.93 Unspecified chorioretinal inflammation, H31.021 Solar retinopathy, right H31.022 Solar retinopathy, left H31.023 Solar retinopathy, H31.101 Choroidal degeneration, unspecified, right H31.102 Choroidal degeneration, unspecified, left H31.103 Choroidal degeneration, unspecified, H31.111 Age-related choroidal atrophy, right H31.112 Age-related choroidal atrophy, left H31.113 Age-related choroidal atrophy, H31.121 Diffuse secondary atrophy of choroid, right H31.122 Diffuse secondary atrophy of choroid, left H31.123 Diffuse secondary atrophy of choroid, H31.21 Choroideremia H31.29 Other hereditary choroidal dystrophy H31.321 Choroidal rupture, right H31.322 Choroidal rupture, left H31.323 Choroidal rupture, H31.411 Hemorrhagic choroidal detachment, right H31.412 Hemorrhagic choroidal detachment, left H31.413 Hemorrhagic choroidal detachment, H31.421 Serous choroidal detachment, right H31.422 Serous choroidal detachment, left H31.423 Serous choroidal detachment, H32 Chorioretinal disorders in diseases classified elsewhere H33.101 Unspecified retinoschisis, right H33.102 Unspecified retinoschisis, left H33.103 Unspecified retinoschisis, H33.111 Cyst of ora serrata, right H33.112 Cyst of ora serrata, left H33.113 Cyst of ora serrata, H33.191 Other retinoschisis and retinal cysts, right H33.192 Other retinoschisis and retinal cysts, left H33.193 Other retinoschisis and retinal cysts, H33.21 Serous retinal detachment, right H33.22 Serous retinal detachment, left H33.23 Serous retinal detachment, H34.01 Transient retinal artery occlusion, right H34.02 Transient retinal artery occlusion, left H34.03 Transient retinal artery occlusion, H34.11 Central retinal artery occlusion, right H34.12 Central retinal artery occlusion, left H34.13 Central retinal artery occlusion, H34.231 Retinal artery branch occlusion, right Printed on 1/29/2018. Page 13 of 24
ICD-10 Codes H34.232 Retinal artery branch occlusion, left H34.233 Retinal artery branch occlusion, H34.8110 Central retinal vein occlusion, right, with macular edema H34.8111 Central retinal vein occlusion, right, with retinal neovascularization H34.8112 Central retinal vein occlusion, right, stable H34.8120 Central retinal vein occlusion, left, with macular edema H34.8121 Central retinal vein occlusion, left, with retinal neovascularization H34.8122 Central retinal vein occlusion, left, stable H34.8130 Central retinal vein occlusion,, with macular edema H34.8131 Central retinal vein occlusion,, with retinal neovascularization H34.8132 Central retinal vein occlusion,, stable H34.821 Venous engorgement, right H34.822 Venous engorgement, left H34.823 Venous engorgement, H34.8310 Tributary (branch) retinal vein occlusion, right, with macular edema H34.8311 Tributary (branch) retinal vein occlusion, right, with retinal neovascularization H34.8312 Tributary (branch) retinal vein occlusion, right, stable H34.8320 Tributary (branch) retinal vein occlusion, left, with macular edema H34.8321 Tributary (branch) retinal vein occlusion, left, with retinal neovascularization H34.8322 Tributary (branch) retinal vein occlusion, left, stable H34.8330 Tributary (branch) retinal vein occlusion,, with macular edema H34.8331 Tributary (branch) retinal vein occlusion,, with retinal neovascularization H34.8332 Tributary (branch) retinal vein occlusion,, stable H34.9 Unspecified retinal vascular occlusion H35.021 Exudative retinopathy, right H35.022 Exudative retinopathy, left H35.023 Exudative retinopathy, H35.031 Hypertensive retinopathy, right H35.032 Hypertensive retinopathy, left H35.033 Hypertensive retinopathy, H35.041 Retinal micro-aneurysms, unspecified, right H35.042 Retinal micro-aneurysms, unspecified, left H35.043 Retinal micro-aneurysms, unspecified, H35.051 Retinal neovascularization, unspecified, right H35.052 Retinal neovascularization, unspecified, left H35.053 Retinal neovascularization, unspecified, H35.061 Retinal vasculitis, right H35.062 Retinal vasculitis, left H35.063 Retinal vasculitis, H35.071 Retinal telangiectasis, right H35.072 Retinal telangiectasis, left H35.073 Retinal telangiectasis, H35.09 Other intraretinal microvascular abnormalities H35.21 Other non-diabetic proliferative retinopathy, right H35.22 Other non-diabetic proliferative retinopathy, left H35.23 Other non-diabetic proliferative retinopathy, H35.3111 Nonexudative age-related macular degeneration, right, early dry stage H35.3112 Nonexudative age-related macular degeneration, right, intermediate dry stage H35.3113 Nonexudative age-related macular degeneration, right, advanced atrophic without subfoveal involvement H35.3114 Nonexudative age-related macular degeneration, right, advanced atrophic with subfoveal involvement H35.3121 Nonexudative age-related macular degeneration, left, early dry stage H35.3122 Nonexudative age-related macular degeneration, left, intermediate dry stage H35.3123 Nonexudative age-related macular degeneration, left, advanced atrophic without subfoveal involvement H35.3124 Nonexudative age-related macular degeneration, left, advanced atrophic with subfoveal involvement Printed on 1/29/2018. Page 14 of 24
ICD-10 Codes H35.3131 Nonexudative age-related macular degeneration,, early dry stage H35.3132 Nonexudative age-related macular degeneration,, intermediate dry stage H35.3133 Nonexudative age-related macular degeneration,, advanced atrophic without subfoveal involvement H35.3134 Nonexudative age-related macular degeneration,, advanced atrophic with subfoveal involvement H35.3211 Exudative age-related macular degeneration, right, with active choroidal neovascularization H35.3212 Exudative age-related macular degeneration, right, with inactive choroidal neovascularization H35.3213 Exudative age-related macular degeneration, right, with inactive scar H35.3221 Exudative age-related macular degeneration, left, with active choroidal neovascularization H35.3222 Exudative age-related macular degeneration, left, with inactive choroidal neovascularization H35.3223 Exudative age-related macular degeneration, left, with inactive scar H35.3231 Exudative age-related macular degeneration,, with active choroidal neovascularization H35.3232 Exudative age-related macular degeneration,, with inactive choroidal neovascularization H35.3233 Exudative age-related macular degeneration,, with inactive scar H35.33 Angioid streaks of macula H35.341 Macular cyst, hole, or pseudohole, right H35.342 Macular cyst, hole, or pseudohole, left H35.343 Macular cyst, hole, or pseudohole, H35.351 Cystoid macular degeneration, right H35.352 Cystoid macular degeneration, left H35.353 Cystoid macular degeneration, H35.361 Drusen (degenerative) of macula, right H35.362 Drusen (degenerative) of macula, left H35.363 Drusen (degenerative) of macula, H35.371 Puckering of macula, right H35.372 Puckering of macula, left H35.373 Puckering of macula, H35.381 Toxic maculopathy, right H35.382 Toxic maculopathy, left H35.383 Toxic maculopathy, H35.52 Pigmentary retinal dystrophy H35.53 Other dystrophies primarily involving the sensory retina H35.54 Dystrophies primarily involving the retinal pigment epithelium H35.61 Retinal hemorrhage, right H35.62 Retinal hemorrhage, left H35.63 Retinal hemorrhage, H35.711 Central serous chorioretinopathy, right H35.712 Central serous chorioretinopathy, left H35.713 Central serous chorioretinopathy, H35.721 Serous detachment of retinal pigment epithelium, right H35.722 Serous detachment of retinal pigment epithelium, left H35.723 Serous detachment of retinal pigment epithelium, H35.731 Hemorrhagic detachment of retinal pigment epithelium, right H35.732 Hemorrhagic detachment of retinal pigment epithelium, left H35.733 Hemorrhagic detachment of retinal pigment epithelium, H35.81 Retinal edema H35.82 Retinal ischemia H43.11 Vitreous hemorrhage, right H43.12 Vitreous hemorrhage, left H43.13 Vitreous hemorrhage, H43.821 Vitreomacular adhesion, right H43.822 Vitreomacular adhesion, left H43.823 Vitreomacular adhesion, H43.89 Other disorders of vitreous body H43.9 Unspecified disorder of vitreous body H44.21 Degenerative myopia, right H44.22 Degenerative myopia, left Printed on 1/29/2018. Page 15 of 24
ICD-10 Codes H44.23 Degenerative myopia, H44.2A1 Degenerative myopia with choroidal neovascularization, right H44.2A2 Degenerative myopia with choroidal neovascularization, left H44.2A3 Degenerative myopia with choroidal neovascularization, H44.2B1 Degenerative myopia with macular hole, right H44.2B2 Degenerative myopia with macular hole, left H44.2B3 Degenerative myopia with macular hole, H44.2E1 Degenerative myopia with other maculopathy, right H44.2E2 Degenerative myopia with other maculopathy, left H44.2E3 Degenerative myopia with other maculopathy, H46.01 Optic papillitis, right H46.02 Optic papillitis, left H46.03 Optic papillitis, H47.011 Ischemic optic neuropathy, right H47.012 Ischemic optic neuropathy, left H47.013 Ischemic optic neuropathy, H47.10 Unspecified papilledema H47.321 Drusen of optic disc, right H47.322 Drusen of optic disc, left H47.323 Drusen of optic disc, H47.331 Pseudopapilledema of optic disc, right H47.332 Pseudopapilledema of optic disc, left H47.333 Pseudopapilledema of optic disc, H47.391 Other disorders of optic disc, right H47.392 Other disorders of optic disc, left H47.393 Other disorders of optic disc, H59.031 Cystoid macular edema following cataract surgery, right H59.032 Cystoid macular edema following cataract surgery, left H59.033 Cystoid macular edema following cataract surgery, M06.9 Rheumatoid arthritis, unspecified Q14.8 Other congenital malformations of posterior segment of Z79.899 Other long term (current) drug therapy Group 2 Paragraph: ICD-10 Codes For Indocyanine Green Angiography (92240) Group 2 Codes: ICD-10 Codes A18.53 Tuberculous chorioretinitis D31.31 Benign neoplasm of right choroid D31.32 Benign neoplasm of left choroid H30.101 Unspecified disseminated chorioretinal inflammation, right H30.102 Unspecified disseminated chorioretinal inflammation, left H30.103 Unspecified disseminated chorioretinal inflammation, H30.111 Disseminated chorioretinal inflammation of posterior pole, right H30.112 Disseminated chorioretinal inflammation of posterior pole, left H30.113 Disseminated chorioretinal inflammation of posterior pole, H30.121 Disseminated chorioretinal inflammation, peripheral right H30.122 Disseminated chorioretinal inflammation, peripheral, left H30.123 Disseminated chorioretinal inflammation, peripheral, H30.131 Disseminated chorioretinal inflammation, generalized, right H30.132 Disseminated chorioretinal inflammation, generalized, left H30.133 Disseminated chorioretinal inflammation, generalized, H31.8 Other specified disorders of choroid Printed on 1/29/2018. Page 16 of 24