Corneal Tissue Procurement / Acquisition
This article is for ambulatory surgical centers (ASCs) and hospital outpatient departments (HOPDs) that submit claims to Medicare for preserving and transporting of corneal tissue.
Medicare makes separate payment for corneal tissue procurement/acquisition when used in corneal transplant procedures described by one of the following CPT and HCPCS codes:
- 65710 (Keratoplasty (corneal transplant); anterior lamellar)
- 65730 (Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)
- 65750 (Keratoplasty (corneal transplant); penetrating (in aphakia))
- 65755 (Keratoplasty (corneal transplant); penetrating (in pseudophakia))
- 65756 (Keratoplasty (corneal transplant); endothelial and any successor code or new code describing a new type of corneal transplant procedure that uses eye banked corneal tissue
- V2785 (Processing, preserving, and transporting corneal tissue) should only be reported when corneal tissue is used in a corneal transplant procedure
Note: V2785 should not be reported in any other circumstances.
ASCs
Under the ASC payment system, Medicare makes separate payment to ASCs for corneal tissue acquisition.
Payment is based on acquisition cost/invoice. If an invoice is not included, the claim may be denied.
HOPDs
Corneal tissue acquisition is paid on a cost basis, not under the Outpatient Prospective Payment System.
To receive cost-based reimbursement, submit charges for corneal tissue acquisition using HCPCS code V2785.
Claim Submission
Paper - Attach the invoice of the acquisition cost.
Note: Check our Discover the Basics of the Administrative Simplification Compliance Act (ASCA) for exceptions to bill.
EMC - Report the acquisition cost using the narrative description field, 2300 loop.
Reference