The following is intended to provide eye care professionals with information related to billing, coding, and reimbursement requirements that may apply to TearScience® products. This is intended for general informational and educational purposes only and is not intended, and does not constitute, reimbursement or legal advice.
Codes identified here do not guarantee coverage or payment at any specific level and is not intended to increase or maximize payment by any payer. Note that laws, regulations and coverage policies are complex and are updated frequently.
Additionally, reimbursement policies vary widely from insurer to insurer and will reflect different patient conditions. Eye care providers should check the current law and regulations and insurer’s policies to confirm the most current coverage, coding or billing requirements. Questions should be directed to your attorneys or reimbursement specialist. Ultimately, the eye care professional is responsible for all aspects of reimbursement, including using codes that accurately reflect the patient’s condition, procedures performed, and products used and ensuring the veracity of all claims submitted to third party payers.
LipiScan, LipiView® II and LipiFlow® are new technology. There is no known insurance coverage or payment established for LipiView® II interferometry (CPT 0330T) or for the LipiFlow® thermal pulsation treatment (CPT 0207T). Insurance coverage and payment do exist for standard dry eye exams defined long ago and for certain products and treatments established in the 1990s or prior.
TearScience® provides ongoing guidance and support on reimbursement issues for medical practices.