Medicare Reimbursement for SCODI of the Posterior Segment

Topic: SCODI-P Maestro2

Sponsor: Topcon Medical Systems

Updated: 03/08/2022

Topcon Healthcare

This FAQ addresses the following:

  1. Does Medicare cover SCODI of the posterior segment with Topcon’s 3D OCT-1 Maestro2?
  2. What CPT codes describe SCODI-P?
  3. What are the indications for SCODI-P?
  4. What documentation is required in the medical record to support a claim for SCODI-P?
  5. Are there payment restrictions or bundles that limit what other codes may be billed the same day?
  6. How much does Medicare allow for this test?
  7. How often may SCODI-P be repeated?
  8. Is the physician’s presence required while SCODI-P is being performed?
  9. If coverage of is unlikely or uncertain, how should we proceed?