extended ophthalmoscopy (proc 92226) part of annual AMD exam?

Hi. This year the annual eye exam included procedure code 92226 ~
twice.
As you've already guessed, the insurer regards this procedure as
something
outside the realm of a routine annual follow-up exam of an AMD
patient.
With whom should I be annoyed: the medical group for padding the old
exam
with new procedure codes, or with the insurer for taking exception to
a
routine procedure? Any illumination will be appreciated.

Thank you,
Jake

P.S. The exam went well. The doc and I plan to meet again next year.