Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Key Coverage Criteria
Correction of surgically induced astigmatism with a corneal relaxing incision or corneal wedge resection is consideredmedically necessarywhenallof the following criteria are met:
The astigmatism is the result of a previous cataract surgery, medically necessary refractive surgery, scleral buckling for retinal detachment, or corneal transplant;and
The degree of astigmatism is 3.00 diopters or greater;and
The medical record documents inadequate functional vision with any of the following: (1) contact lenses, (2) spectacles, or (3) contact lenses and spectacles.
Laser in-situ keratomileusis (LASIK), laser epithelial keratomileusis (LASEK), photorefractive keratectomy (PRK), and photoastigmatic keratectomy (PARK or PRK-A) are consideredmedically necessarywhenallof the following are met:
Prior cataract, corneal, or scleral buckling surgery for retinal detachment has been performed on this eye;and