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Medicare Reimbursement for Optical Coherence Biometry

Topic: Optical Coherence Biometry

Sponsor: Corcoran Consulting Group

Updated: 01/14/2019

Corcoran Consulting Group

Most Medicare administrative contractors (MACs) have published local coverage determination (LCD) policies on optical coherence biometry or have discussed it in their A-scan biometry policies.

This FAQ addresses the following:

  1. What is optical coherence biometry (OCB)?
  2. What documentation is required in the medical record to support this service?
  3. Does Medicare pay for this test?
  4. How do we submit the claim to Medicare?
  5. How much does Medicare allow for this test?
  6. How frequently is OCB performed?
  7. Will Medicare cover repeat testing?
  8. If we perform both OCB and A-scan biometry prior to cataract surgery with IOL, may we be reimbursed for both?
  9. Must the physician be present while this test is being performed?