Surgical Correction of Corneal Astigmatism
“Astigmatism may be either pre-existing or iatrogenic (e.g., induced by the effects of treatment, usually surgery). Medicare covers refractive surgery in the rare instances when it is performed to correct a surgical complication or trauma. Surgically induced astigmatism may be covered; treatment of pre-existing astigmatism is considered refractive surgery and is non-covered.”
This FAQ addresses the following:
- What options are available for the correction of corneal astigmatism?
- Does Medicare cover surgery to correct corneal astigmatism?
- Does Medicare specify the amount of surgically induced astigmatism that must be present to be covered?
- If the payer determines that SCOCA is covered, how should the procedure be coded?
- Why doesn’t Medicare cover procedures to correct pre-existing astigmatism?
- How do we identify refractive surgical procedures for correction of pre-existing astigmatism?
- Are special tests required prior to surgery?
- Will these tests be reimbursed?
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