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Reimbursement for Ophthalmic Ultrasound (Accutome Inc.)

This monograph describes reimbursement for ultrasound imaging and diagnostic testing performed with several Accutome ultrasound instruments. 

These instruments image the anterior and posterior segments of the eye, and the orbital tissue.  The A-scan, B-Scan, and UBM instruments can connect to office-based computer systems via a DICOM-compatible export function.

Much of the information is taken from official publications of the Medicare program, including the Centers for Medicare & 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 and ICD-10-CM.  Documentation of the medical necessity for any test or procedure is a prerequisite to reimbursement, so the required elements in detail are described herein. 

Since economic analyses are a necessary part of any capital budgeting decision, we incorporated Medicare’s payment rates for the testing as well as utilization rates.


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Provided Courtesy of Accutome Inc.


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