Medicare Reimbursement for Endothelial Cell Count

Topic: Endothelial Cell Count

Sponsor: Nidek

Updated: 04/24/2018


This FAQ addresses the following:

  1. Does Medicare cover endothelial cell count performed with Nidek’s CEM-530 specular microscope?
  2. Are there any limitations on coverage?
  3. Is the physician’s presence required while the test is being performed?
  4. Will ECC be reimbursed if performed on the same day as an eye exam or another diagnostic test?
  5. What documentation is required in the medical record to support claims for ECC?
  6. How much does Medicare allow for this test?
  7. How often may this test be repeated on a patient?
  8. If coverage of ECC is unlikely or uncertain, how should we proceed?