Medicare Reimbursement for Optical Coherence Biometry

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Topic: Optical Coherence Biometry

Sponsor: ZEISS

Updated: 05/13/2019

This FAQ addresses the following:

Does Medicare pay for optical coherence biometry (OCB) using Carl Zeiss Meditec’s IOL Master?
What clinical conditions support a claim for OCB testing?
What documentation is required in the medical record to support a claim for OCB?
What CPT code describes OCB?
How do we submit the claim to Medicare?
How much does Medicare allow for this test?
How frequently is OCB performed?
Will Medicare cover repeat testing?
Must the physician be present while this test is being performed?
If we perform both OCB and A-scan biometry prior to cataract surgery with IOL, may we be reimbursed for both?

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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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