Indocyanine Green Angiography

Indocyanine green (ICG) angiography is covered as an adjunct to fluorescein angiography for diagnosis and management of acute posterior multifocal placoid pigment epitheliopathy, exudative senile (neovascular) macular degeneration, hemorrhagic detachment of the retinal pigment epithelium, monitoring of foveomacular vitelliform (Best) disease, and retinal hemorrhage. Coverage requires documentation showing one of: an ill‑defined/suspicious subretinal neovascular membrane on prior FA, presence of subretinal hemorrhage or hemorrhagic RPE (FA not required), or absence of subretinal neovascular membrane on current FA, with physician documentation supporting frequency/medical necessity; intraoperative ICG tissue‑perfusion imaging is integral to the primary surgery and not separately reimbursed.

"ICD-10 codes covered if selection criteria are met: H35."

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