New medical policies for ocular photoscreening and otoacoustic emissions testing


The medical policies below apply to our commercial plans and go into effect Sept. 1, 2019:

  • Medical policy: Ocular photoscreening (commercial plans)
    Instrument-based ocular screening using photoscreening will be covered as medically necessary for vision screening for the following:
    • As a preventive screening for children 1 to 3 years of age 
    • Individuals 4 years of age and older who are developmentally delayed and are unable or unwilling to cooperate with routine visual acuity screening
  • Medical policy: Otoacoustic emissions testing (commercial plans)
    This new policy includes guidelines for the following covered indications for CPT code 92558:
    • Neonatal hearing screening as a preventive service using otoacoustic emissions (OAEs) is proven and/or medically necessary for infants who are 90 days or younger.
    • Evoked otoacoustic emissions is considered medically necessary to screen children 3 years of age and younger who did not have the initial neonatal screening and/or cannot be effectively measured or monitored through audiometry. 

Please refer to the policies for more details.