Reimbursement for Ultrasonic Biomicroscopy (Quantel Medical)

This monograph describes reimbursement for anterior segment ultrasonic ultrasonic biomicroscopy performed with the Quantel Aviso and Compact Touch Ultrasonic Biometers.

The Quantel Aviso and Compact Touch Ultrasonic Biometers are capable of high resolution ultrasound images of the anterior segment of the eye. Both are portable, have adjustable gain settings, and contain post-processing calipers and other measurement tools.

Ultrasound can visualize features of tissue (e.g., fluid, solid mass) that are generally not available except through radiological or tomographic study. It can provide a view through cloudy media to obtain high resolution tissue detail for structures posterior to the opacity. Finally, structures in the images can be accurately measured with these devices once an image is captured, hence the term “biometer” in the descriptor. Examples of anterior segment anatomy that may be evaluated include:

  • Conjunctiva
  • Sclera
  • Cornea
  • Anterior chamber angle
  • Iris
  • Ciliary body
  • Lens

Ultrasound images of the eye are generated in two dimensions (also known as a B-scan); when the anterior segment alone is imaged, it is referred to as ultrasonic biomicroscopy (UBM).

Much of the information is taken from official publications of the Medicare program, including the Centers for Medicare and Medicaid (CMS) and the Medicare Administrative Contractors (MAC). However, the reader is encouraged to check with the local MAC for additional information and instructions as not all guidelines are the same. 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-9-CM. Documentation of the medical necessity of for any test or procedure is a pre-requisite 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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Provided Courtesy of Quantel Medical.

 

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