Phototherapeutic Keratectomy

This policy covers phototherapeutic keratectomy (PTK) for treatment of anterior corneal disease—including superficial corneal dystrophies (e.g., granular, lattice, Reis‑Bückler), epithelial basement membrane dystrophy, Salzmann’s nodular degeneration and keratoconus nodules, anterior stromal scars/opacities (post‑traumatic, post‑infectious, postsurgical), and recurrent corneal erosions that have failed conservative management—to improve corneal clarity, smooth irregular surfaces, and promote epithelial adhesion. PTK is not intended for primary refractive correction (PRK is appropriate for refractive errors), is investigational for indications not listed, requires exhaustion of conservative therapies where applicable, and coverage is subject to the member’s benefit plan and known risks (e.g., induced refractive error, corneal scarring, glare/halos, and recurrence).

"Superficial corneal dystrophy (including granular, lattice, and Reis-Bückler's dystrophy)."