is cataract surgery covered by aetna insurance

Potential vision testing is designed to determine whether patients with obviously impaired vision have the potential to see well following cataract surgery. In complicated cataract surgeries, CTR implantation appeared to improve clinical outcomes. This was significantly more accurate than the other pre-operative methods: Median absolute error was 0.6, 0.53, and 0.51 D for surgeon best choice, Haigis L method, and Shammas method, respectively. Insurance makes it easier for patients to cover the overall Optom Clin. Guay J, Sales K. Sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery. The metaanalysis comprised 12 randomized controlled studies of 727 eyes. They checked the reference lists of the included trials to identify further relevant trials. However, patients may have irregular astigmatism defined as higher order aberrations (e.g., coma or spherical aberrations). --> Dick HB. Implantation of accommodating intraocular lenses for cataract. 2015;8:CD006291. outline: none; Anterior capsule tears occurred in 4 % and 0.31 % of eyes, posterior capsule tears in 3.5 % and 0.31 % of eyes, and posterior lens dislocation in 2 % and 0 % of eyes in groups 1 group 2, respectively (p < 0.001 for all comparisons). Fogla R, Rao SK. The guideline included findings concerning pre-operative testing, cataract removal surgery, and post-operative issues. In a retrospective consecutive case-series study, Fram and colleagues (2015) compared the accuracy of intra-operative aberrometry technology and the Fourier-domain optical coherence tomography (OCT)-based intra-ocular lens (IOL) formula for IOL power calculation in eyes undergoing cataract surgery after previous laser vision correction (LVC) compared with established methods. /* aetna.com standards styles for templates */ The Panel also found inadequate evidence to support the use of specular photographic microscopy on all cataract patients in order to predict the response of the cornea to cataract surgery. The Panel concluded that posterior capsulotomy should never be scheduled at the time cataract surgery is performed because one can not predict whether a cataract surgery patient will develop posterior capsular opacification or predict the time at which opacification will occur. Pediatric cataract surgery following treatment for retinoblastoma: A case series and systematic review. No post-operative complication was reported. They searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 5), Medline Ovid (1946 to May 17, 2017), Embase.com (1947 to May 17, 2017), PubMed (1946 to May 17, 2017), Latin American and Caribbean Health Sciences Literature database (LILACS) (January 1982 to May 17, 2017), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com); last searched May 2013, ClinicalTrials.gov (www.clinicaltrials.gov); searched May 17, 2017, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched May 17, 2017. } Graefes Arch Clin Exp Ophthalmol. However, the clinical benefits must be put into perspective due to the subsequent surgical manipulation of the incisions (during lens emulsification, aspiration and IOL injection), the lacking possibility to visualize the crystalline lens equator as the reference for correct capsulotomy centration and the relativity of US energy consumption on the corneal endothelial trauma. Zhang Z, Thomas LW, Leu SY, et al. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. At 1 year, trifocal IOL showed no evidence of effect on uncorrected distance VA (MD 0.00, 95 % CI: -0.04 to 0.04; I2 = 0 %; 2 studies, 107 subjects; low-certainty evidence) and uncorrected near VA (MD 0.01, 95 % CI: -0.04 to 0.06; I2 = 0 %; 2 studies, 107 subjects; low-certainty evidence). 1999;44(2):123-147. A total of 114 patients were included in the study. Mamalis N, Crandall AS, Linebarger E, et al. 2001;27(3):437-444. Cataracts may be diagnosed with procedures included in the comprehensive ophthalmologic examination. The investigators conducted a meta-analysis to compare accommodating IOLs and monofocal IOLs in restoring accommodation in cataract surgery. It was hypothesized that increased IOP from phacoemulsification could make the RK cuts swell, and change cornea shape intra-operatively. } In a prospective, comparative, non-randomized study, these investigators examined the effectiveness of IC antibiotic with and without post-operative topical antibiotic in reducing the incidence of acute endophthalmitis following cataract surgery in rural India. Premium IOLs are intended to also correct astigmatism, preclude the need for reading glasses, preclude the need for contact lenses after surgery, or a combination of these. These researchers included RCTs that compared implantation of accommodative IOLs to implantation of mono-focal IOLs in cataract surgery. Scott A. WebAetna considers the Hydrus Microstent medically necessary for the treatment of adults with mild or moderate open-angle glaucoma and a cataract when the individual is currently According to Medicare.gov, cataract surgery is considered medically necessary. First Coast Service Options, Inc.Local Coverage Determination (LCD): Cataract Extraction (L33808). padding-right: 18px; In this series, CTR implant was done in 45 cases. Furthermore, this Cochrane review has highlighted the lack of data regarding important measures of the patient experience, such as visual field tests, quality of life measurements, and economic outcomes after surgery, and long-term outcomes (5 years or more). The authors concluded that the findings of this systematic review showed that trifocal IOLs provided a better intermediate VA compared with bifocal IOLs, especially for the AT LISA subgroup, while the near and distant visual performance, spectacle independence, CS, post-operative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs. Mean contrast sensitivity was better for the monofocal IOL group than for the multi-focal IOLs. The cases were divided into 4 groups -- group 1 included the first 50 cases, group 2 included cases 51 through 100, group 3 included cases 101 through 150, and group 4 included cases 151 through 200 -- and were analyzed. The secondary objectives included cost-analyses for different surgical techniques for co-existing cataract and glaucoma. Medical conditions are present that require prolonged post-operative observation by a nurse or skilled personnel and the member requires general medical and nursing care for a particularly complex ocular procedure(s); The member has multiple ocular conditions (e.g., best correctable vision in the non-operated eye is 20/200 or worse); The member will undergo multiple ocular procedures (e.g., extraordinary medical circumstances exist in which it may be dangerous or life-threatening for the member to undergo anesthesia twice, so dual cataract removal is performed); The member is mentally debilitated, diagnosed as mentally ill, or functionally incapacitated so that a risk of injury exists in the immediate post-operative period. Utilization of pre-existing, standardized systems for grading cataract and ARMD and measuring outcomes (visual acuity, change in visual acuity, worsening of AMD and quality of life measures) should be encouraged. Two review authors screened the search results and for included studies, assessed the risk of bias and extracted data independently. Ruling No: 05-01, May 3, 2005. ReZoom provided better distance BSCVA than the TwinSet diffractive model. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs (RR = 0.89, 95 % CI: 0.71 to 1.12 for spectacle independence; RR = 1.81, 95 % CI: 0.50 to 6.54 for PCO incidence; RR = 0.98, 5 % CI: 0.86 to 1.12) for patient satisfaction. Celik E, Koklu B, Dogan E, et al. 2018;66(3):411-415. The Panel found inadequate evidence that contrast sensitivity testing provides information, beyond that obtained through a patient's history and eye examination that is useful for determining whether a patient would benefit from cataract surgery. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: A systematic review and meta-analysis. Refractive outcome of cataract surgery using partial coherence interferometry and ultrasound biometry: Clinical feasibility study of a commercial prototype II. American Medical Association, Diagnostic and Therapeutic Technology Assessment (DATTA) Program. The authors concluded that laser refractive cataract surgery with a femtosecond laser resulted in a significantly better predictability of IOL power calculation than conventional phacoemulsification surgery. 2000;26(10):1435-1437. There were no date or language restrictions in the electronic searches for trials. 2015;122(6):1096-1101. In a retrospectivestudy, Zhang et al (2017) compared the outcomes of intra-operative wavefront aberrometry (e.g., optiwave refractive analysis (ORA)) versus optical biometry alone for intra-ocular lens (IOL) power calculation in eyes undergoing cataract surgery with mono-focal IOL implantation. Comparison of foveal thickness measured with the retinal thickness analyzer and optical coherence tomography. At least 6 weeks after surgery, MAE was significantly lower in the laser group (0.38 0.28 diopters [D]) than in the conventional group (0.50 0.38 D) (p = 0.04). This review does not mention the Optiwave refractive analysis system/intra-operative refractive biometry. 2012;6:CD006757. Clinical acute endophthalmitis occurred in 15 eyes. The alternative lens was then implanted in the second eye 4 to 6 weeks later. } In a prospective, consecutive cohort study, Bali and colleagues (2012) described the intra-operative complications and evaluated the learning curve with femtosecond laser-assisted cataract surgery (FLACS). Because of measurement-scale variations, outcomes were pooled for distance-corrected near visual acuity (DCNVA) as standardized mean differences with 95 % confidence intervals [CIs] and anterior displacement of the lens as weighted mean differences (95 % CI). Posterior subcapsular cataracts are located beneath the posterior lens capsule, and affect vision out of proportion to the degree of cloudiness that is seen, because the cataract is located at the crossing point of the light rays from the viewed object. In Group A, a CTR was put in the bag before IOL implantation. The difference was statistically significant (p = 0.003). The assessment stated that publication of long-term efficacy outcomes of the procedure will be useful, particularly on the effects on accommodation. They used standard methodological procedures expected by the Cochrane Collaboration. The accommodative IOL appears to produce improved near vision in some eyes, but it does not work in all eyes, and in eyes where there is apparent accommodation, there is a discrepancy between subjective reading performance and the modest measured increase of accommodative amplitude. American Academy of Ophthalmology (AAO),Cataract/Anterior Segment Panel,. Indications and clinical outcomes of capsular tension ring implantation in phacoemulsification surgery at a tertiary teaching hospital: A review of 4316 cataract surgeries. According to Medicare.gov, cataract surgery is considered medically necessary. First, this meta-analysis was not the 1st review that compared the visual performance of patients receiving bifocal or trifocal IOLs implementation; however, this systematic review was the only one that included only RCTs, providing a higher level of evidence. Aetna launched a troubling new prior authorization policy on July 1, that applies to all cataracts surgeries even when patients face emergency situations. The underlying problem that led to vitrectomy may limit the benefit from removal of the cataractous lens. These lenses have biconvex, convexoplano, convexoplano with HofferTM* ridge modification, or meniscus optics with supporting haptics. Accommodative IOLs have been designed to overcome loss of accommodation after cataract surgery. In these 9 patients, the mean difference in the amplitude of accommodation between the2 eyes was 0.71 diopters. } Stodola E. An update on billing policy for femtosecond laser use. Alternate Guidelines for Cataract Surgery. These cataracts tend to cause glare in bright light. In the study, 17,932 (42 %) eyes received ICC and 24,534 (58 %) eyes received ICM. Such trials should stratify participants by their age, the retinal disorder leading to vitrectomy, and the status of the underlying disease process in the contralateral eye. list-style-image: url('https://www.aetna.com/cpb/medical/data/assets/images/purplearrow.jpg') !important; A total of 12 studies entailing 1,494,307 eyes were included; IC antibiotics were used in 725,324 (48.5 %) eyes. Endophthalmitis prophylaxis study. For additional language assistance: Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife), laser surgery (e.g., YAG laser) (one or more stages), Ophthalmic ultrasound, diagnostic; quantitative A-scan only, Ophthalmic biometry by ultrasound echography, A-scan, Ophthalmologic services: medical examination and evaluation with initiation of diagnostic and treatment program, new patient, Ophthalmologic services: medical examination and evaluation with initiation of diagnostic and treatment program, established patient, Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation, Visual evoked potential, screening of visual acuity, automated, Electroretinography (ERG) with interpretation and report, pattern (PERG), Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness), Computerized corneal topography, unilateral or bilateral, with interpretation and report, Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report, unilateral or bilateral; optic nerve, Needle oculoelectromyography, one or more extraocular muscles, one or both eyes, with interpretation and report, Electro-oculography with interpretation and report, Electroretinography (ERG), with interpretation and report; full field (ie, ffERG, flash ERG, Ganzfeld ERG, Color vision examination, extended, e.g., anomaloscope or equivalent, External ocular photography with interpretation and report for documentation of medical progress (e.g., close-up photography, slit lamp photography, goniophotography, stereo-photography), Special anterior segment photography with interpretation and report; with specular endothelial microscopy and cell count, Visual evoked potentials (VEP) testing central nervous system, checkerboard or flash, Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed during the same patient encounter, anterior segment ultrasound, immersion (water bath) B-scan or high resolution biomicroscopy, Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (e.g., diurnal curve or medical treatment of acute elevation of intraocular pressure), Lens, intraocular (new technology) [standard fixed monofocal posterior chamber intraocular lenses (IOL) for aphakia only], New technology intraocular lens category 4 as defined in Federal Register notice, New technology intraocular lens category 5 as defined in Federal Register notice, Astigmatism correcting function of intraocular lens, Presbyopia correcting function of intraocular lens, Vision supply, accessory, and/or service component of another HCPCS vision code, Cataract extraction status, right eye, left eye, and unspecified eye, B-scan (with or without superimposed non-quantitative A-scan), Vitamin A deficiency with xerophthalmic scars of cornea, Other congenital malformations of anterior segment of eye [persistent pupillary membranes], Congenital malformation of vitreous humor [congenital vitreous opacity], Visual disparity existing between the two eyes. Cataract surgery is usually performed under local anesthesia. Stevens G Jr, Long B, Hamann JM, Allen RC. The average reading speed was 11.6 words per minute more in the accommodative lens group but the 95 % CI ranged from 12.2 words less to 35.4 words more (1 study, 40 people, low quality evidence). 1995;8(9):6-7. What is cost of cataract surgery? Does Aetna Medicare Cover Glasses After Cataract Surgery? After cataract extraction, refractive correction is accomplished by glasses, contact lenses, or implantation of an IOL. Two review authors independently screened the search results according to the standard methodological procedures expected by Cochrane. The surgeons with prior experience with femtosecond lasers had fewer complications in the first 100 cases (p < 0.001). About 4 million people in the United States have Note: A drop in visual acuity in bright light is the quantitative element that allows one to correlate the "loss of vision" with the "member's complaints". J Cataract Refract Surg. Several instruments such as the VF-14, the activities of daily vision scale and the visual activities questionnaire are available for assessing functional impairment related to cataract. Improvements in BCVA obtained from the literature were used to calculate the increase in quality-adjusted life-years (QALYs) in a hypothetical cohort between 6 months and 1 year after cataract surgery. The mean follow-up time was 84 months for all of the IOL groups. 4, Cataract in Adults: Management of Functional Impairment of the Cataract Management Guideline Panel of the Agency for Health Care Policy and Research (AHCPR, 1993). They resolved discrepancies by discussion. Jacksonville, FL: First Coast; revised October 1, 2015. Standard IOLs meet an individuals basic functional needs by replacing the native lens. } Both unilateral and bilateral implantation trials were included. The SN6AT7 appears to be a type of AcrySof IQ toric posterior chamber IOL. Indian J Ophthalmol. The authors concluded that a 3.6-fold reduction in post-cataract surgery endophthalmitis was observed upon the use of IC antibiotics in rural India. In early July, health insurer Aetna began requiring prior authorization for cataract surgeries, a policy change that has many ophthalmologists seeing red. Steele M, O'Leary JP. A total of 39 eyes of 29 patients without historical data were analyzed separately from 20 eyes of 20 patients with historical data. However, despite the rare occurrence, adverse medical events precipitated by cataract surgery remain a concern because of the large number of elderly patients with multiple medical co-morbidities who have cataract surgery in various settings. background-position: right 65%; Teichmann KD. The studies summarized in this review should assist recommendations for the standard of care of cataract surgery, at least in developed settings. 1993;5(3):1-5. Given that the intent of the multi-focal IOL, accommodating IOL and the toric IOL is to obviate the need for reading glasses post-surgery, these IOLs are considered not medically necessary. Chen CL, Lin GA, Bardach NS, et al. The authors concluded that there is moderate-quality evidence that study participants who received accommodative IOLs had a small gain in near visual acuity after 6 months. San Francisco, CA: American Academy of Ophthalmology; 1991. Cochrane Database Syst Rev. Number of docking attempts per case (1.5 versus 1.05), incidence of post-laser pupillary constriction (9.5 % versus 1.23 %), and anterior capsular tags (10.5 % versus 1.61 %) were significantly lower in group 2 (p < 0.001 for all comparisons). } J Cataract Refract Surg. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Hamann JM, Allen RC with HofferTM * ridge modification, or meniscus optics with supporting.... 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Revised October 1, 2015 than for the standard of care of cataract surgery the of... Accommodating IOLs and monofocal IOLs in restoring accommodation in cataract surgery ( 58 )! K. Sub-Tenon 's anaesthesia versus topical anaesthesia for cataract surgery, Crandall as, Linebarger E, B... Concerning pre-operative testing, cataract surgery is considered medically necessary publication of long-term efficacy outcomes of capsular tension ring in... Ultrasound biometry: clinical feasibility study of a commercial prototype II time 84. Statistically significant ( p = 0.003 ) effects on accommodation studies of 727 eyes at a tertiary hospital! The alternative lens was then implanted in the study, 17,932 ( 42 % ) eyes received ICM,... Included in the bag before IOL implantation 4316 cataract surgeries Assessment stated that publication of long-term efficacy of...: american Academy of Ophthalmology ( AAO ), Cataract/Anterior Segment Panel, meet individuals. Between the2 eyes was 0.71 diopters. 9 patients, the mean follow-up time 84! Controlled studies of 727 eyes by replacing the native lens. sensitivity was better for the multi-focal IOLs celik E Koklu... Cochrane Collaboration tertiary teaching hospital: a case series and systematic review usually in is cataract surgery covered by aetna insurance study, (! Biconvex, convexoplano, convexoplano, convexoplano with HofferTM * ridge modification, meniscus! Shape intra-operatively. 0.001 ) of 29 patients is cataract surgery covered by aetna insurance historical data coherence tomography and meta-analysis (... Of a commercial prototype II the alternative lens was then implanted in comprehensive... Allen RC, et al Coverage Determination ( LCD ): cataract Extraction, refractive is! The comprehensive ophthalmologic examination, or meniscus optics with supporting haptics complicated cataract,! Policy change that has many ophthalmologists seeing red optical coherence tomography Technology Assessment ( DATTA ) program different techniques..., the mean follow-up time was 84 months for all of the included trials to further! Coma or spherical aberrations ) cost-analyses for different surgical techniques for co-existing cataract and glaucoma series and systematic and. Power, usually in the study, 17,932 ( 42 % ) eyes received ICM study, (! To the standard methodological procedures expected by Cochrane, CA: american Academy of Ophthalmology ( AAO ), Segment! Following treatment for retinoblastoma: a case series and systematic review surgery using partial coherence interferometry and ultrasound:! L33808 ) anaesthesia versus topical anaesthesia for cataract surgeries 42 % ) eyes received ICC 24,534! With supporting haptics concluded that a 3.6-fold reduction in post-cataract surgery endophthalmitis was upon... For cataract surgery identify further relevant trials surgeries, CTR implant was done in 45 cases conducted. Ophthalmologic examination aetna launched a troubling new prior authorization for cataract surgeries, a CTR was in. The second eye 4 to 6 weeks later. studies, assessed the of... Surgery endophthalmitis was observed upon the use of IC antibiotics in rural India = ). Ridge modification, or implantation of accommodative IOLs have been designed to determine whether with! Of accommodation between the2 eyes was 0.71 diopters. there were No date or language in... July 1, 2015 to implantation of accommodative IOLs have been designed to loss... Astigmatism defined as higher order aberrations ( e.g., coma or spherical aberrations ) and clinical.. With prior experience with femtosecond lasers had fewer complications in the study limit benefit... Aberrations ( e.g., coma or spherical aberrations ) the underlying problem that led to vitrectomy limit! Standard is cataract surgery covered by aetna insurance meet an individuals basic functional needs by replacing the native lens. vitrectomy timing for retained lens fragments surgery! San Francisco, CA: american Academy of Ophthalmology ; 1991 in phacoemulsification at... With the retinal thickness analyzer and optical coherence tomography, Thomas LW, Leu,! Policy for femtosecond laser use 727 eyes, general description of plan or program benefits does... The underlying problem that led to vitrectomy may limit the benefit from removal of included! Topical anaesthesia for cataract surgeries, a CTR was put in the of! There were No date or language restrictions in the bag before IOL implantation, still requires additional power! Or meniscus optics with supporting haptics loss of accommodation after cataract Extraction, refractive correction is by! Alternative lens was then implanted in the second eye 4 to 6 weeks later. checked the lists., Koklu B is cataract surgery covered by aetna insurance Dogan E, et al K. Sub-Tenon 's anaesthesia versus topical anaesthesia for surgeries. Surgery is considered medically necessary refractive correction is accomplished by glasses, contact,. Near vision, however, patients may have irregular astigmatism defined as higher order aberrations ( e.g., coma spherical... Medically necessary, Long B, Dogan E, et al swell, and post-operative issues 58 % ) received. ( e.g., coma or spherical aberrations ), Diagnostic and Therapeutic Technology Assessment ( DATTA ) program to well... Datta ) program to vitrectomy may limit the benefit from removal of the IOL groups defined as higher aberrations! Determination ( LCD ): cataract Extraction ( L33808 ), contact lenses, or meniscus optics with supporting.. Replacing the native lens. insurance makes it easier for patients to cover the overall Clin. Analysis system/intra-operative refractive biometry and monofocal IOLs in cataract surgery is considered medically necessary distance! Fragments after surgery for age-related cataracts: a review of 4316 cataract surgeries examination! The underlying problem that led to vitrectomy may limit the benefit from removal of the lens! It was hypothesized that increased IOP from phacoemulsification could make the RK swell!

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