CG-MED-35 Retinal Telescreening Systems

This policy addresses retinal telescreening systems used in the outpatient setting to screen for diabetic retinopathy. These systems are medically necessary only for annual diabetic retinopathy screening as an alternative to an ophthalmologist/optometrist exam when the individual has no prior known diabetic retinopathy and an FDA-approved device is used for imaging and grading. All other uses are not medically necessary, including monitoring disease progression in known diabetic retinopathy or screening/evaluating other retinal conditions (e.g., macular degeneration).

"Retinal telescreening systems in the outpatient setting are consideredmedically necessaryfor annual diabetic retinopathy screening as an alternative to retinopathy screening by an ophthalmologist o..."

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