Scanning Computerized Opthalmic Diagnostic Imaging

This policy covers Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI), including anterior and posterior segment OCT, for evaluation and diagnosis of a broad range of anterior and posterior ocular diseases—commonly used for suspected or early glaucoma (e.g., optic nerve/nerve fiber layer defects, visual field abnormalities, elevated IOP), corneal disease (ulcer, edema, degeneration, transplant issues), iris and orbital pathologies, and retinal assessment. Coverage is limited to mild-to-moderate glaucoma (SCODI is not medically necessary for advanced glaucomatous damage or for glaucoma screening), time-domain OCT is inadequate for certain screenings, spectral-domain OCT is preferred/expected for baseline and annual CQ/HCQ retinal toxicity monitoring, vitreous degeneration/membranes are excluded, and Health Plan/state Medicaid rules may affect applicability.

"SCODI for evaluation of anterior and posterior segment ocular diseases (general use stated in policy description)."