Reimbursement for Diagnostic Tests

Topic: Corneal Topography

Sponsor: ZEISS

Updated: 11/02/2017


This monograph describes reimbursement for diagnostic tests performed with the ZEISS Atlas 9000 Corneal Topography system, either alone or as part of another service.

Much of the information in this document is taken from official publications of the Medicare program. The reader is encouraged to check with the local Medicare Administrative Contractor (MAC) for additional information and instructions. In the case of other third party payers, we have used the coding concepts contained in Current Procedural Terminology (CPT) and published by the American Medical Association (AMA); diagnosis codes are from the International Classification of Diseases (ICD), ICD-10-CM (10th edition). Documentation of a diagnostic test, and the medical rationale for it, are key to reimbursement so we describe the required elements in detail.

Since economic analyses are a necessary part of any capital budgeting decision, we incorporated Medicare’s payment rates for the procedure as well as utilization rates.