Ultrasound, A-scan, ophthalmic biometry.The following specialized ophthalmologic services are considered medically necessary for the routine pre-operative work-up for cataract surgery:
Other pre-operative ophthalmologic tests may be considered medically necessary if there is another diagnosis in addition to cataracts. Note: B-scan ultrasound is considered medically necessary for pre-operative work-up of individuals with Morgagnian cataract. Footnote1*įootnote1* B-scan ultrasound is considered medically necessary in place of A-scan ultrasound where direct visualization of the retina is difficult or impossible including lid problems (e.g., severe edema, partial or total tarsorrhaphy), keratoprosthesis, corneal opacities (e.g., scars, severe edema), hyphema, hypopyon, miosis, dense cataract, pupillary membranes, or vitreous opacities (e.g., hemorrhage, inflammatory debris). In addition to a comprehensive or brief/intermediate eye examination, A-mode ultrasound (A-scan) may be considered medically necessary prior to cataract surgery to determine the appropriate pseudophakic power of the IOL. This Clinical Policy Bulletin addresses cataract surgery.Īetna considers the following procedures medically necessary as a diagnostic test prior to cataract surgery: Number: 0508 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background References
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