Does S0621 require prior authorization?

No, S0621 does not require prior authorization (high confidence). Covered without prior authorization.

What is the Medicare reimbursement rate for S0621?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

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`S0621`, Routine ophthalmological examination including refraction; established patient

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Record visual acuity with current correction (power documented) at distance and, when appropriate, at near; include refraction when indicated.
Document visual fields by confrontation or automated screening devices (non-threshold).

Document slit-lamp biomicroscopic exam: eyelid margins/lashes, tear film, conjunctiva, sclera, cornea, anterior chamber (central and peripheral depth), iris, lens, and anterior vitreous.

Key Coverage Criteria

Routine preventive ophthalmic evaluation to detect common and serious ocular abnormalities.
Periodic re-examination of all patients, with emphasis on those who have risk factors for ocular disease, to prevent or minimize vision loss through early detection and treatment.
Preventive (routine) eye examinations to evaluate the visual system and related ocular structures.
Periodic re‑examination after an initial comprehensive exam that is normal or only shows refractive (optical) abnormalities to detect new or asymptomatic ocular disease (examples: glaucoma, diabetic retinopathy, age‑related macular degeneration).
Comprehensive evaluations for patients with no risk factors at routine intervals (frequencies specified elsewhere in the policy).
Pediatrics: follow CPG.VP.47 Pediatric Eye Examinations.

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`S0621`, Routine ophthalmological examination including refraction; established patient

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

Have a follow-up question?

S0621, Routine ophthalmological examination including refraction; established patient

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

1 Active Policy

Related Codes

Have a follow-up question?

`S0621`, Routine ophthalmological examination including refraction; established patient