0402T — Colgn crs-link crn&pachymtry
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Evidence of progression such as changes in refraction, visual acuity, or corneal shape
- Objective documentation of progression (for example, an increase of ≥1.0 diopter in the steepest keratometry value)
- Subjective manifest refraction documenting the specified change in astigmatism (≥1.0 D) or spherical equivalent (≥0.50 D).
- Measurement documentation of back optical zone radius showing a decrease ≥0.1 mm for rigid contact lens wearers when other data are unavailable.
Key Coverage Criteria
- Progressive keratoconus
- Corneal ectasia following refractive surgery
- Progression documented by clinical change (e.g., increase of ≥1.0 diopter in the steepest keratometry value)
- Progressive keratoconus or corneal ectasia following refractive surgery.
- Progression defined by an increase of 1.0 diopter (D) in regular astigmatism on subjective manifest refraction.
- Progression defined by a myopic shift of ≥0.50 D (decrease in spherical equivalent) on subjective manifest refraction.
5 Active Policies
BCBSIL-OTH903.028 — Corneal Collagen Cross-Linking
BCBSMT-OTH903.028 — Corneal Collagen Cross-Linking
BCBSNM-OTH903.028 — Corneal Collagen Cross-Linking
BCBSOK-OTH903.028 — Corneal Collagen Cross-Linking
OTH903.028 — Corneal Collagen Cross-Linking
Related Codes
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