Reimbursement for Diagnostic Tests with the Carl Zeiss Meditec IOLMaster

This monograph describes reimbursement for diagnostic tests performed with Carl Zeiss Meditec’s IOLMaster optical biometry systems, either alone or as part of another service.

Much of the information in this document is taken from official publications of the Medicare program. 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 Current Procedural Terminology (CPT) and published by the American Medical Association (AMA); diagnosis codes are from the International Classification of Diseases (ICD), ICD-10-CM (10th edition). Documentation of a diagnostic test, and the medical rationale for it, 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 for the procedures as well as utilization rates.

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