Medicare Reimbursement for E-Swin Tearcheck

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Topic: Tearcheck

Sponsor: e-Swin USA

Updated: 08/09/2023

This FAQ addresses the following:

What is the E-Swin tearcheck?
What CPT codes should we use to describe tearcheck?
Does keratoconjunctivitis sicca (H16.22-), not specified as Sjogren’s, support 92285?
Is the physician’s presence required while external photography is being performed?
What documentation is required in the medical record to support claims for 92285 and 0330T?
Does Medicare cover external photography and tear film imaging?
What does Medicare allow for external photography and tear film imaging?
What is the frequency of external photography in the Medicare program?
How often may this test be repeated?
If coverage of external photography is unlikely or uncertain, how should we proceed?

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The reimbursement information is provided by Corcoran Consulting Group based on publicly available information from CMS, the AMA, and other sources. The reader is strongly encouraged to review federal and state laws, regulations, code sets, and official instructions promulgated by Medicare and other payers. This document is not an official source nor is it a complete guide on reimbursement. Although we believe this information is accurate at the time of publication, the reader is reminded that this information, including references and hyperlinks, changes over time, and may be incorrect at any time following publication.

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