Extended Ophthalmoscopy

Aetna covers extended ophthalmoscopy for posterior segment conditions such as blunt/periorbital injury; chorioretinitis, chorioretinal scars, choroidal degeneration, dystrophies, hemorrhage, rupture, or detachment; choroidal nevus surveillance; degenerative globe disorders; and diabetic retinopathy/retinal vascular occlusion/retinal separation, but considers it experimental/investigational for congenital hypertrophy of the retinal pigment epithelium. Coverage is limited to medically necessary use — it is not covered after a normal routine ophthalmoscopy, not for routine repeated exams without change in signs/symptoms, and not when other imaging already provides the needed information unless additional non‑duplicative information is expected; frequency is based on clinical indication.

"Blunt injury to the eye or periorbital structures"

Sign up to see full coverage criteria, indications, and limitations.