What Medicare covers is not always clear-cut. A breakdown of cataract surgery and the rationale for who pays what.
Donna McCune, CCS-P, COE
A. Medicare’s National Coverage Determination (NCD) §10.1 states the following: “In most cases, a comprehensive eye examination (ocular history and ocular examination) and a single scan to determine the appropriate pseudophakic power of the IOL are sufficient. In most cases involving a simple cataract, a diagnostic ultrasound A-scan is used. For patients with a dense cataract, an ultrasound B-scan may be used.