An intraocular lens is a hard type of artificial lens which is surgically implanted in the eye to replace the natural crystalline lens.
Pseudophakos Intraocular Lens
The intraocular lenses listed below are covered prosthetic devices and are processed under the applicable procedure codes, subject to benefit coverage:
The intraocular lenses listed below are not covered prosthetic devices, as their purpose is to avoid the need for glasses following cataract surgery. Corrective lenses provided solely for refractive error or to compensate for the imperfect curvature of the cornea (astigmatism) are not a standard benefit and are excluded from coverage.
If a member chooses to have a presbyopia or astigmatism-correcting intraocular lens following cataract surgery, the lens itself will be denied as non-covered.
Any additional pre-, and intra post-operative services beyond those typically provided in conjunction with a cataract extraction with insertion of a standard IOL will also be denied as non-covered.
Phakic intraocular lenses are not covered prosthetic devices, as their purpose is to avoid the need for glasses. They are not a standard benefit and are excluded from coverage.
Ocular Telescopic Prosthesis including removal of Crystalline Lens is considered experimental/investigational.
When the presbyopia-correcting or astigmatism-correcting intraocular lens is inserted solely for the correction of refractive errors or to compensate for the imperfect curvature of the cornea (i.e., not for cataract surgery), the lens, the surgical procedure, and all pre- and post-operative care will deny as non-covered and will entirely be the member’s financial responsibility.