Does 00103 require prior authorization?

No, 00103 does not require prior authorization (low confidence). No active coverage policies found for this code.

What is the Medicare reimbursement rate for 00103?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

HCPCS/CPT

No Prior Auth Required

No active coverage policies found for this code (low confidence)

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Repair of a functional defect caused by trauma, tumor, or surgery;or
Periorbital sequelae of thyroid disease;or
Nerve palsy.
Occlusion Amblyopia (also known as deprivation amblyopia)
Upper eyelid blepharoplasty or blepharoptosis repair is consideredmedically necessaryto treat occlusion amblyopia when BOTH of the following criteria are met:
Individual is less than or equal to 9 years of age*;and

ANTHEM-CG-SURG-03 — CG-SURG-03 Blepharoplasty, Blepharoptosis Repair, and Brow Lift

ANTHEM-CG-MED-21 — CG-MED-21 Anesthesia Services and Moderate (âConsciousâ) Sedation

ANTHEM-MED.00103 — MED.00103 Automated Evacuation of Meibomian Gland

ANTHEM-CG-SURG-118 — CG-SURG-118 Intraocular Anterior Segment Aqueous Drainage Devices (without extraocular reservoir)

Ask Verity about documentation requirements, denial risks, or coverage in your state.