Ophthalmic Biometry for Intraocular Lens Power Calculation

Ophthalmic biometry (A-scan, B-scan when dense, or OCB) is covered to calculate IOL power for patients who have elected and whose surgeon has agreed to cataract removal with IOL implantation, normally limited to one preoperative scan and one comprehensive eye exam. The technical component is typically treated as bilateral and valid for 12 months (repeat scans within 12 months require documentation of significant visual change or a different unaffiliated surgeon), and additional tests beyond the single scan are covered only with documentation of an additional diagnosis and medical necessity.

"Ophthalmic biometry (A-scan ultrasound or optical coherence biometry) is covered for patients undergoing cataract surgery with an intraocular lens (IOL) implant to calculate IOL power."

Sign up to see full coverage criteria, indications, and limitations.