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BREAKING: Academy Wins Vitrectomy Medicare Coverage Restoration

Thursday, January 11, 2018   (0 Comments)
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BREAKING: Academy Wins Vitrectomy Medicare Coverage Restoration

The Academy received word directly from the Centers for Medicare & Medicaid Services last night that the agency will instruct its contractor to restore recently eliminated diagnoses codes associated with national coverage decisions for vitrectomy procedures. The Academy led a successful effort to halt an implementation of a substantial number of deleted diagnoses codes, which took place in October.

CMS says it will take a few days for the Medicare Administrative Contractors to fully implement this change but expects that will be completed within the week. 

The agency also assured the Academy that it would work with us to review the covered diagnoses.

Visit for more details as they become available.

CMS authorized deletion of nearly 25 percent of vitrectomy’s diagnoses codes, including those for vitreous hemorrhage, macular hole and macular pucker. The deletions were part of an effort to clean up its volume of ICD-10 codes associated with national coverage decisions.

Still, the sheer number of diagnoses deleted was a shocking and perplexing development. The Academy remains diligent in efforts to ensure continued access to procedures often done on an emergency basis.

If you have additional questions, contact Cherie McNett at