Billing and Coding: ArgusM II Retinal Prosthesis System

The ArgusM II retinal prosthesis (CPT 0100T) is covered for adults age ≥25 with severe to profound retinitis pigmentosa (ICD-10 H35.52) who have bare light or no light perception in both eyes, a prior history of useful form vision, appropriate lens status, and documented ability to participate in post-implant follow-up and rehabilitation. Implantation is intended for a single (typically worse-seeing) eye; claims must include H35.52 and medical records must document how all indication criteria were met. Replacement parts are billed with L8608 and require the part name and invoice.

"Diagnosis of severe to profound retinitis pigmentosa documented in the medical record."

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