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Computer-assisted corneal topography (also called photokeratoscopy) provides a quantitative measure of corneal curvature. Measurement of corneal topography is being evaluated to aid the diagnosis and follow-up of corneal disorders such as keratoconus, difficult contact lens fits, and pre- and postoperative assessment of the cornea, most commonly after refractive surgery.
Corneal topography describes measurements of the curvature of the cornea. An evaluation of corneal topography is necessary for the accurate diagnosis and follow-up of certain corneal disorders, such as keratoconus, difficult contact lens fits, and pre- and postoperative assessment of the cornea, most commonly after refractive surgery. Various techniques and instruments are available to measure corneal topography:
A number of devices have received clearance for marketing through the Food and Drug Administration (FDA) 510(k) mechanism. The Orbscan® (manufactured by Orbtek and distributed by Bausch and Lomb) received FDA clearance in 1999. The second generation Orbscan II is a hybrid system that uses both projective (slit scanning) and reflective (Placido) methods. The Pentacam® (Oculus) is one of a number of rotating Scheimpflug imaging systems produced in Germany.
POLICYNon-computer-assisted corneal topography is considered part of the evaluation and management services of general ophthalmological services (CPT codes 92002-92014), and therefore this service should not be billed separately. There is no separate CPT code for this type of corneal topography.
Computer-assisted corneal topography is considered not medically necessary to detect or monitor diseases of the cornea.
POLICY EXCEPTIONSFederal Employee Program (FEP) may dictate that all FDA-approved devices, drugs or biologics may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity.
POLICY GUIDELINESThe coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
Non-computer-assisted corneal topography should be considered inclusive to evaluation and management services.
POLICY HISTORY12/19/2006: Policy added
3/5/2007: Code Reference section updated per quarterly HCPCS revisions
3/22/2007: Reviewed and approved by the Medical Policy Advisory Committee (MPAC)
1/10/2008: Policy reviewed, no changes
4/24/2009: Policy reviewed, policy statement changed from investigational to not medically necessary
04/28/2010: Policy description and statement unchanged. FEP verbiage added to the Policy Exceptions section.
06/22/2011: Policy reviewed; no changes.
05/09/2012: Policy reviewed; no changes.
05/08/2013: Policy reviewed; no changes to policy statement. Removed deleted HCPCS code S0820 from the Code Reference section.
07/01/2014: Policy reviewed; description updated. Policy statement unchanged.
07/13/2015: Code Reference section updated for ICD-10.
09/16/2015: Policy description updated regarding devices. Policy statements unchanged.
04/22/2016: Policy title changed from "Corneal Topography/Computer-Assisted Photokeratoscopy" to "Corneal Topography/Computer-Assisted Corneal Topography/Photokeratoscopy." Policy description updated. Policy statements unchanged.
SOURCE(S)Blue Cross Blue Shield Association Policy # 9.03.05
CODE REFERENCEThis may not be comprehensive list of procedure codes applicable to this policy.