Wavefront Aberrometry and Medicare – Ophthalmology Management

Determination of the refractive state of the eye is the most common ophthalmic ancillary diagnostic test performed in-office in conjunction with an eye exam. While there are numerous ways to measure refractive error, subjective refraction is the customary method. The result describes the amount of lower-order aberrations in the eye, including defocus (sphere), cylinder and tilt (prism).

This method is adequate in most cases, but some patients still complain of poor vision, which manifests as halos or glare even though their visual acuity is nominally 20/20. In ophthalmologists’ quest to fully appreciate and understand the problems of these patients and to find a way to ameliorate them, it is useful to consider higher-order aberrations as well (e.g., spherical aberration, coma, trefoil, etc.). To do so, eyecare providers employ wavefront aberrometry, which is both objective and more thorough than the traditional subjective refraction.

This article answers the following questions:

  • What CPT code best describes wavefront aberrometry?
  • Does Medicare reimburse practices for wavefront aberrometry?\
  • Must we get an Advance Beneficiary Notice of Noncoverage (ABN) signed in order to collect from the patient?

This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:


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