Medicare Reimbursement for Endothelial Cell Count
Medicare covers endothelial cell count performed with a specular microscope when medically necessary. Medicare has a national coverage determination policy (NCD 80.8) addressing reimbursement for endothelial cell count (ECC), also known as endothelial cell photography or specular microscopy.
This FAQ addresses the following:
- Does Medicare cover endothelial cell count performed with a specular microscope?
- What is Medicare’s coverage policy?
- Are there any limitations on coverage?
- Is the physician’s presence required while the test is being performed?
- Will ECC be reimbursed if performed on the same day as an eye exam or another diagnostic test?
- What documentation is required in the medical record to support claims for ECC?
- How much does Medicare allow for this test?
- How often may this test be repeated on a patient?
- If coverage of ECC is unlikely or uncertain, how should we proceed?
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