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  • Experimental Denial for Amniotic Membrane Tissue

    A local insurance carrier is denying insertion of an amniotic membrane tissue, stating CPT 65778 is experimental and not covered. How do we get paid?

    Commercially managed plans can set their own policy. It is best to verify coverage, including need for prior authorization, prior to the procedure.
    Find additional coding competency resources in Fundamentals of Ophthalmic Coding.