• Non-Covered Diagnosis for AMT Placement


    Question: The patient’s insurance plan does not cover the reason the patient needs CPT code 65778 Amnionic membrane transplant. Would insurance still cover the treatment if we believe it is medically necessary?

    Answer: When you know by the insurance plan policy that the AMT is not payable for the patient’s diagnosis, the patient is responsible for payment. You may also choose to go through the appeals process, as can the patient.

    Learn more about minor surgeries in Ophthalmic Coding: Learn to Code Cornea.