3/5/2012

Cigna currently covers a standard monofocal intraocular lens implant as medically necessary to meet the basic functional needs of an individual who undergoes removal of the crystalline lens as part of cataract surgery.  Beginning May 21, 2012 Cigna will update their Intraocular Lens Coverage Policy for the following intraocular lens implants and professional services.  Additional information is available on Cigna’s secure website for Health Care Professionals.

CPT/HCPCS Code Description of Service Policy Updates Effective May 21, 2012
66985 Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal Remove coverage when used to report the implantation of a non-covered lens or when performed for a non-covered indication.
66986 Exchange of intraocular lens Remove coverage when used to report the implantation of a non-covered lens or when performed for a non-covered indication.
C1780 Lens, intraocular (new technology) Remove coverage when implanted for disorders of refraction or accommodation. Treatment of refractive errors is not considered medically necessary.
Q1003 New technology intraocular lens category three (reduced spherical aberration) Remove coverage when implanted for disorders of refraction or accommodation. Treatment of refractive errors is not considered medically necessary.
V2630 Anterior chamber intraocular lens Remove coverage when implanted for disorders of refraction or accommodation. Treatment of refractive errors is not considered medically necessary.
V2631 Iris supported intraocular lens Remove coverage when implanted for disorders of refraction or accommodation. Treatment of refractive errors is not considered medically necessary.
V2632 Posterior chamber intraocular lens Remove coverage when implanted for disorders of refraction or accommodation. Treatment of refractive errors is not considered medically necessary.
V2787 Astigmatism correcting function of intraocular lens Remove coverage. These lens implants are premium lenses, and are not considered medically necessary.
V2788 Presbyopia correcting function of intraocular lens Remove coverage. These lens implants are premium lenses, and are not considered medically necessary.