Medicare Reimbursement for Endothelial Cell Count

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Topic: Endothelial Cell Count

Sponsor: Topcon Medical Systems

Updated: 07/01/2018

This FAQ addresses the following:

Does Medicare cover endo-thelial cell count (ECC) performed with Topcon’s SP-1P specular microscope?
What is Medicare’s coverage policy as noted in NCD 80.8?
Are there any limitations on this policy?
Are there additional indications besides those noted in Medicare’s NCD 80.8?
Will ECC be reimbursed if performed on the same day as an eye exam or another diagnostic test?
How should we document ECC in the medical record?
How much does Medicare allow for this test?
How often may this test be repeated on a patient?
May we ever bill the patient directly for this test?

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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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