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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

November 2018

Newly Covered Codes for Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)


In the May issue of Network Matters, Harvard Pilgrim announced that we created a new commercial medical policy for the management of SCODI, which includes confocal laser scanning ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography. Effective immediately, we are adding numerous codes to the list of covered ICD-10 diagnosis codes attached to the policy. This coding expansion includes, but is not limited to, the addition of diagnosis codes for retinal disorders such as macular degeneration and retinal neuropathy. As a reminder, Harvard Pilgrim covers the following CPT codes only when they are submitted with a covered diagnosis code (the complete updated list of these codes is attached to the medical policy) and all the criteria indicated on the policy are met:

  • 92132 – Scanning computerized ophthalmic diagnostic imaging, anterior segment, with interpretation and report, unilateral or bilateral
  • 92133 – Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve
  • 92134 – Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; retina

Prior authorization is not required for coverage of SCODI. For complete information, please refer to Harvard Pilgrim’s updated Scanning Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI) Medical Policy.

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PUBLICATION INFORMATION

Robert Farias,
Senior Vice President, Corporate Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator