Payer PolicyActive
Glaucoma Testing
AETNA-CPB-0622
Aetna
Effective: September 12, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna covers computerized visual field testing, gonioscopy, and OCT measurement of the optic nerve head and retinal nerve fiber layer (CPT 92020, 92081–92083, 92133, 92134) as medically necessary for evaluation of primary open‑angle glaucoma, with coverage contingent on meeting the policy’s selection criteria. Aetna considers continuous IOP monitoring, genotyping, home perimetry, home tonometry (e.g., Icare Home), and corneal hysteresis measurement experimental/investigational and not covered.
Coverage Criteria Preview
Key requirements from the full policy
"No explicit 'Indications' or 'Covered Indications' section appears in this document excerpt."
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