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Medicare Reimbursement for Corneal Pachymetry
Topic: Corneal Pachymetry
Sponsor: Corcoran Consulting Group
Updated: 01/24/2020
Corneal pachymetry is a measurement of the thickness of the cornea. The normal human cornea is approximately 550 microns thick centrally and a full millimeter thick peripherally. A pachy-meter is most often used to measure the central cornea, although there are diseases that warrant a “patchette” or pachymetry grid across a wide area..
Pachymetry is customarily ordered when a diseased cornea is edematous or ectatic. It is also used prior to LASIK to help plan the photoablation and in glaucoma evaluations.
This FAQ addresses the following:
- What is corneal pachymetry?
- What are the indications for corneal pachymetry?
- What CPT code describes this test?
- What documentation is required to support a claim for corneal pachymetry?
- Does Medicare cover corneal pachymetry?
- Is the physician’s presence required while pachymetry is being performed?
- How much does Medicare allow for corneal pachymetry?
- If coverage of pachymetry is unlikely or uncertain, how should we proceed?
- How frequently is this test performed?
A Pachymetry Interpretation Report is also included.