Medicare Reimbursement for SCODI of the Posterior Segment

Topic: SCODI-P

Sponsor: Heidelberg Engineering

Updated: 06/18/2024

Heidelberg Engineering

This FAQ addresses the following:

  1. What is SCODI of the posterior segment performed with Heidelberg Engineering’s SPECTRALIS®?
  2. Does Medicare cover SCODI of the posterior segment?
  3. Is the physician’s presence required while SCODI-P is being performed?
  4. What documentation is required in the medical record to support claims for SCODI-P?
  5. What CPT codes should we use to describe SCODI-P?
  6. How much does Medicare allow for these tests?
  7. What payment restrictions or bundles exist for SCODI-P and other ophthalmic services?
  8. How often may SCODI-P be repeated?
  9. If coverage for SCODI-P is unlikely or uncertain, how should we proceed?