Fluorescein Angiography

This policy covers fluorescein angiography for evaluation and management of retinal and choroidal disorders, including choroidal neovascular membranes, RPE lesions/tears/detachments, age‑related macular degeneration, vitreous hemorrhage, retinal vascular disease (e.g., CRVO/BRVO), macular edema, and diabetic retinopathy (non‑edematous forms). Major limitations/requirements include initial post‑treatment angiography only at ≥6 weeks, routine follow‑up limited to as often as every 8–12 weeks unless dictated by disease progression, diabetic retinopathy indications restricted to cases without macular edema, attention to imaging artifacts/filter maintenance, and coverage subject to the member’s plan and applicable state/Medicaid rules.

"Initial evaluation when ophthalmoscopy shows choroidal neovascular membranes."

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