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• The keratometer (also referred to as an ophthalmometer), the most commonly used instrument, projects an illuminated image onto a central area in the cornea. By measuring the distance between a pair of reflected points in both of the cornea’s two principal meridians, the keratometer can estimate the radius of curvature of two meridians. The fact that the keratometer can only estimate the corneal curvature over a small percentage of its surface, and that estimates are based on the frequently incorrect assumption that the cornea is spherical, are limitations of this technique.
• The keratoscope is an instrument that reflects a series of concentric circular rings off the anterior corneal surface. Visual inspection of the shape and spacing of the concentric rings provides a qualitative assessment of topography. A photokeratoscope is a keratoscope equipped with a camera that can provide a permanent record of the corneal topography.
• Computer-assisted photokeratoscopy is an alternative to keratometry or keratoscopy in measuring corneal curvature. This technique uses sophisticated image analysis programs to provide quantitative corneal topographic data. For example, computer-based programs can combine with keratoscopy to create graphic displays and high-resolution color-coded maps of the corneal surface.  Newer technologies mesure both curvature and shape, enabling quantitative assessment of corneal depth, elevation and power.

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.

Computer-assisted corneal topography is considered not medically necessary to detect or monitor diseases of the cornea.

Non-computer assisted corneal topography should be considered inclusive to evaluation/and management services.

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.

All codes billed for this procedure are considered investigational and not eligible for coverage.

Non-Covered Codes

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