About this policy
CMS National Coverage Determination | ncd_id=239 | manual_section=80.12 | coverage_level_code=2 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
Intraocular lens implantation services, as well as the lens itself, may be covered if reasonable and necessary for the individual. Implantation services may include hospital, surgical, and other medical services, including pre-implantation ultrasound (A-scan) eye measurement of one or both eyes.
Documentation requirements
Item/Service Description: An intraocular lens, or pseudophakos, is an artificial lens which may be implanted to replace the natural lens after cataract surgery. Cross Reference: See the Medicare Benefit Policy Manual , Chapter 6 §10, Chapter 15 §120, and Chapter 16 §§20 and 90. Revision History: 03/1997 - Revised because FDA no longer uses the categories identified in this section to classify IOLs, and FDA no longer has adjunct studies for IOLs. Effective date 05/19/1997. (TN 93) 07/1991 - Revised to reflect that Medicare no longer covers most investigational IOLs. Effective date 05/30/1991. (TN 50) Benefit Categories: 58 - Prosthetic Devices Transmittal: transmittal_number=93 | transmittal_issue_date=1997-03-01
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
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