Reimbursement for TECNIS Symfony® IOL

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Topic: Presbyoptic IOL

Sponsor: Abbott Medical Optics

Updated: 08/19/2016

This FAQ addresses the following:

What is the Abbott TECNIS Symfony® IOL?
Does Medicare differentiate between EDOF and conventional IOLs for reimbursement purposes?
Are there other noncovered expenses associated with presbyopia-correcting IOLs?
How should we tell Medicare beneficiaries about the noncovered charges associated with an EDOF IOL?
Are specific codes assigned and reported to Medicare or other payers to describe the noncovered items or services?
How does the facility report the upgrade lens charge on a claim form?
Is it necessary to segregate the ASC charges from the surgeon’s charges?

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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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