Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

SCODI (including OCT, confocal scanning, and scanning laser polarimetry modalities) is covered for evaluation and management of retinal disorders and glaucoma, and for specified anterior-segment indications (narrow-angle glaucoma, IOL calculation after prior refractive surgery, iris tumor, and when corneal opacity precludes visualization). SD-OCT is required for baseline and annual monitoring of patients on long-term chloroquine or hydroxychloroquine; scanning laser polarimetry is not appropriate for retinal disorder management. Generally, up to 2 SCODI exams per eye per year are expected for glaucoma management, and certain other ocular imaging procedures (fundus photography, extended ophthalmoscopy with drawing, B-scan) are considered generally unnecessary the same day unless justified in the record; payment limitations apply for cataract-related billing when A-scan or IOL Master are used.

"SCODI is medically reasonable and necessary for evaluating retinal disorders, including macular abnormalities and retinal thickness assessment."