Ophthalmic Angiography (Fluorescein and Indocyanine Green)

Fluorescein angiography is covered as a medically necessary diagnostic adjunct for a range of chorioretinal vascular disorders (notably CNV, noninfective vasculitis, AMD), select inflammatory, neoplastic, and diabetic-retinopathy indications, including post-treatment monitoring. Indocyanine green (ICG) angiography is covered as an adjunct to fluorescein for deeper choroidal evaluation (eg, ill-defined CNV, choroidal leakage, RPE detachments) but is contraindicated in patients with iodine allergy and is not medically necessary for background diabetic retinopathy or for routine screening; direct physician supervision and per-eye documentation of medical necessity are required.

"Fluorescein angiography with interpretation is medically necessary as an adjunct to diagnosis of chorioretinal vascular abnormalities, especially choroidal neovascularization, noninfective vasculit..."