Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

SCODI (including OCT) is covered as medically reasonable and necessary for evaluation and monitoring of glaucoma (especially glaucoma suspects and mild-to-moderate disease) and for retinal disorders, particularly macular disease. SD‑OCT is required for baseline and annual surveillance of long-term chloroquine/hydroxychloroquine users. SCODI is not covered for advanced glaucoma or when used solely as confirmatory testing; concurrent same-day procedures (e.g., fundus photography, ophthalmoscopy, B-scan) or visual field testing within three months generally require documented justification.

"SCODI is medically reasonable and necessary for evaluation and monitoring of glaucoma when clinical data (optic nerve, retinal nerve fiber layer, anterior chamber, and visual field) are being used ..."

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