External Ocular Photography

External ocular photography is covered to document and track progression of external eye, eyelid, anterior segment, and adnexal conditions—such as keratitis/corneal disease, iridocyclitis/anterior chamber inflammation, conjunctivitis, eyelid pathology and neoplasms, trauma/burns, lacrimal abnormalities, lens subluxation, and superficial ocular injuries. Coverage is limited to clinically indicated imaging (e.g., close‑up, slit‑lamp, goniophotography, stereo) and is not medically necessary for routine documentation of normal anatomy, duplicative retinal imaging, or repeated studies when disease is stable; payment is subject to member benefits, contract terms, and applicable state/federal/Medicaid rules.

"External ocular photography is medically necessary to track progression of external ocular conditions affecting the external eye, eyelids, and ocular adnexa."

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