As retinal imaging technology continues to advance, optical coherence tomography angiography (OCT‑A) has become an new tool for diagnosing and monitoring retinal vascular disease. Recognizing this shift, the American Medical Association introduced CPT code 92137 in 2025, to describe OCT imaging that includes angiography capabilities.

Correctly using 92137 is critical—not only for proper reimbursement but also for compliance with updated coding regulations.

CPT 92137 definition

“Computerized ophthalmic diagnostic imaging of the retina, including OCT angiography (OCT‑A), with interpretation and report.”

Key elements:

• It includes both standard OCT and OCT‑A within a single code.
• It is unilateral or bilateral, consistent with other OCT codes.
• It must be performed and interpreted on the same day.

This code exists because OCT‑A is now considered an important clinical procedure that was not adequately described by previous codes (92133/92134) which did not differentiate angiographic imaging.

Use of CPT 92137

Use 92137 only when both OCT and angiography functionality are medically necessary and performed.

Clinical examples include:

• Suspicion or monitoring of choroidal neovascularization (CNV)
• Evaluation of diabetic macular ischemia or edema
• Monitoring retinal vascular diseases
• Cases where non‑invasive angiographic detail impacts medical decision‑making

Do NOT use 92137 for routine OCT without angiography, even if your equipment automatically captures OCT‑A. In such cases, use 92134.

Remember, payers will deny OCT‑A billed without clear medical necessity (or worse, recoup payments in an audit).

Bundling & Restrictions

CPT 92137 cannot be billed with:

• 92133 (OCT – optic nerve)
• 92134 (OCT – retina)

when performed at the same encounter.

This reflects AMA parenthetical instructions and is expected to become enforced via expanded National Correct Coding Initiative (NCCI) edits.

However, 92137 may be billed with:

• 92235 (fluorescein angiography)
• 92240 (ICG angiography)
• 92242 (combined FA/ICG)

This can be necessary for cases of vascular evaluation in severe pathology.

Documentation Requirements

To support CPT 92137, your chart must include:

1. Medical Necessity

You must clearly document why OCT‑A was needed, and how it impacts clinical decision‑making.

2. Physician Order

Like all ophthalmic diagnostic tests, 92137 requires a documented order.

3. Interpretation & Report

A separate, signed report must include:

• Findings
• Clinical relevance
• Impact on diagnosis or treatment

(note that “separate” does not mean that the report has to be a separate piece of paper or separate section in the chart, just that the interpretation and report needs to be clearly identified in the record and include the key elements listed above)

4. Avoid Screening

Performing OCT‑A without a documented indication is considered screening and is not billable, even if pathology is incidentally discovered.

Reimbursement Considerations

Average national reimbursement (2025):

• 92137 (OCT‑A): ~$56.93

And for comparison:

• 92134 (OCT Optic Nerve): ~$31.38
• 92133 (OCT Retina): ~$29.76
• 92132 (OCT Anterior Segment): ~$28.79 

Although reimbursements were reduced by ~22% from 2024, 92137 still offers higher relative revenue due to its advanced imaging capabilities.

Note: Some commercial payers may be slow to update systems for new codes; however, you must still bill the correct code based on the service rendered.

Compliance & Stark Law Considerations

Beginning in 2025, CPT 92137 is classified as a designated health service (DHS) under Stark Law, requiring careful attention to:

• Compensation models
• Self‑referral limitations

Providers in group practices should consult compliance professionals to ensure billing properly aligns with federal law.

Practical Tips

• Train staff to understand when OCT‑A is medically appropriate vs. when standard OCT suffices.
• Update EHR templates to include areas to document specific OCT‑A medical‑necessity elements.
• Verify payer policies, especially as updates roll out.
• Avoid auto‑billing OCT‑A simply because the device captures it—this is a common audit trigger.
• Include ICD‑10 codes consistent with OCT pathology, similar to those used for 92134.

Conclusion

CPT code 92137 represents a major step forward in appropriately capturing the clinical and technological value of OCT angiography. Used correctly, it enhances reimbursement accuracy and supports high‑quality retinal care. For optometrists adopting or expanding OCT‑A use, mastering the guidelines behind 92137 is essential for both compliance and practice success.