Reimbursement Guidelines for Scanning Computerized Ophthalmic Diagnostic Imaging

Topic: SCODI

Sponsor: Optovue

Updated: 01/29/2020


This monograph describes reimbursement for scanning computerized ophthalmic diagnostic imaging including both posterior segment testing (SCODI-P) and anterior segment testing (SCODI-A) performed using Optovue’s iVue®, iFusion™ (iVue combined with the iCam® fundus camera) and Avanti™ instruments.

Much of the information is taken from official publications of the Medicare program. However, 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 CPT and published by the American Medical Association; diagnosis codes are from ICD-10-CM. Documentation of the test, the medical rationale for it, and then proper interpretation 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, as well as utilization rates.