Medicare Reimbursement for Optical Coherence Biometry

Topic: Optical Coherence Biometry

Sponsor: OCULUS

Updated: 08/18/2020


This FAQ addresses the following:

  1. Does Medicare pay for optical coherence biometry (OCB) using OCULUS’ Pentacam® AXL?
  2. What CPT code describes OCB?
  3. For an initial test with OCB, what is the claim to Medicare?
  4. What documentation is required in the medical record to support claims for OCB?
  5. When a patient returns for second eye surgery, what then?
  6. What clinical conditions support a claim for OCB testing?
  7. How much does Medicare allow for this test?
  8. How frequently is OCB performed?
  9. How often may OCB be repeated?
  10. Is the physician’s presence required while OCB is being performed?
  11. If we perform both OCB and A-scan biometry prior to cataract surgery with IOL, may we be reimbursed for both?