Retina and AMD · Diabetes
Diabetic Eye Disease Guide a yearly exam every diabetic patient needs.
Diabetic retinopathy often has no early symptoms, and the National Eye Institute advises a comprehensive dilated exam at least once a year for everyone with diabetes. That makes diabetic eye care one of the most predictable recurring medical services a primary care practice can run.
Quick answer
Examine yearly, image, report back.
Run a structured annual diabetic eye exam with retinal imaging, grade what you find, and send a report to the patient's primary care physician. Refer macular edema and proliferative disease to retina. Health plans track the diabetic eye exam as a quality measure, so primary care offices actively look for reliable eye care partners.
Key takeaways
- The NEI advises a dilated eye exam at least once a year for people with diabetes.
- About 1 in 15 people with diabetes will develop diabetic macular edema, per the NEI.
- Anti-VEGF injections, corticosteroids, laser and surgery are the retina-level treatments.
- Autonomous AI screening can be billed with CPT 92229 where it is used.
- A report back to primary care closes the loop and builds referrals.
Six parts of a diabetic eye service.
Built inside your normal exam schedule.
Annual recall
Flag every diabetic patient for a yearly dilated exam and schedule the next one before they leave.
Dilated exam and grading
Grade retinopathy and look for macular edema at every visit.
Imaging
Color or widefield photos document the periphery; OCT confirms or rules out macular edema.
Report to primary care
Send findings and the recommended interval to the treating physician after each exam.
Retina referral
Refer center-involved edema and proliferative disease promptly with images attached.
Ocular surface care
Diabetes is a recognized dry eye risk factor, so check the surface while the patient is in the chair.
Three ways to screen diabetic patients.
Remote and AI imaging codes as summarized by Optos for 2026 Medicare.
| Model | How it works | Code |
|---|---|---|
| In-office dilated exam | Doctor examines and grades, with imaging as needed | Eye exam or E/M code, plus imaging codes |
| Remote imaging with staff review | Images captured and reviewed remotely | 92227 |
| Remote imaging with physician interpretation | Images read and reported by a physician | 92228 |
| Autonomous AI at point of care | Software returns a result without a clinician read | 92229 |
Your diabetic exam report is a marketing document. A short, consistent letter to each patient's primary care physician, sent every time, is what makes that office send you the next diabetic patient.
Frequently asked questions
How often should patients with diabetes have an eye exam?
The NEI advises a comprehensive dilated eye exam at least once a year. Specialists may set a shorter interval when retinopathy is present.
Does retinopathy cause symptoms early?
Often not. Early diabetic retinopathy may have no symptoms, which is why the yearly exam matters.
What does autonomous AI screening detect?
FDA-authorized systems such as LumineticsCore and EyeArt are designed to detect more-than-mild diabetic retinopathy from retinal images.
Can AI replace the comprehensive exam?
No. It screens for retinopathy. A comprehensive exam evaluates the whole eye, including cataract, glaucoma and the ocular surface.
What treatments do retina specialists use?
The NEI lists anti-VEGF injections, corticosteroids, laser treatment and eye surgery.
Can 92250 and 92134 be billed together?
Payer edits often bundle them. Check each payer before planning same-day photos and OCT.
References
- National Eye Institute. Diabetic retinopathy. NEI
- Optos. 2026 retinal imaging CPT codes and rates. Optos PDF
- Abràmoff MD, et al. Pivotal trial of an autonomous AI-based diagnostic system for detection of diabetic retinopathy in primary care offices. NPJ Digit Med. 2018;1:39. PubMed
- Digital Diagnostics. LumineticsCore. Digital Diagnostics
- Eyenuk. EyeArt. Eyenuk
- Every source used across these guides is listed on the Vision Rescue sources page.
About this guide
Written for licensed eye care practices by the Vision Rescue team. Questions: providers@visionrescue.com or 1-855-692-8024.
Important notes and disclosures
Information only, not clinical or legal advice. Product names are trademarks of their owners and appear for identification; Vision Rescue does not endorse or review them. Scope of practice, coverage and coding rules vary by state and payer, so confirm locally. Clinical decisions rest with the treating eye doctor.
Make the diabetic exam a standing service.
Recall, image, report and refer the same way every time, and keep surface care supplies stocked or routed through RescueLink.