Reimbursement for Tests with the OCULUS Pentacam

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Topic: OCULUS Pentacam

Sponsor: OCULUS

Updated: 03/11/2021

This FAQ addresses the following:

What tests can be performed with the OCULUS Pentacam® and Pentacam® AXL?
Does Medicare cover anterior segment SCODI (SCODI-A)?
Does Medicare cover external ocular photography and corneal topography?
Does Medicare cover corneal Pachymetry?
Does Medicare cover Zernike and wavefront analysis?
What are Medicare’s reimbursement rates for the covered tests?
What documentation is required in the medical record?
Is it possible to bill for more than one test on the same day?
How frequently may tests with the OCULUS Pentacam be performed?
If coverage of a test is unlikely or uncertain, how should we proceed?

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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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