Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

SCODI/OCT is covered when used for specific diagnostic and management purposes of posterior and anterior segment ocular disease, including diagnosis and monitoring of glaucoma, evaluation of retinal and optic nerve pathology, assessment of anterior segment structures (e.g., cornea, iris, lens), and surgical planning. Coverage excludes screening or procedures without a documented clinical indication; cataract-related OCT for patients with prior refractive surgery requires documentation of the prior refractive procedure, and OCT is not reimbursed in addition to A-scan or IOL master for the same cataract service.

"Posterior segment OCT is reasonable and necessary to diagnose and manage retinal and neuro-ophthalmic diseases involving the optic nerve, subretinal and intraretinal abnormalities, vitreoretinal re..."

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