LASIK (laser in situ keratomileusis) is a refractive surgery technique intended to correct myopia, hyperopia and/or astigmatism, thereby reducing or eliminating the need for contact lens or glasses for vision correction. The procedure involves the creation of a flap in a portion of the cornea that is peeled back to expose the inner portions of corneal tissue. Next, a process called photoablation, for which an excimer laser is used, removes microscopic amounts of the internal corneal tissue that changes the curvature of the cornea. Upon completion of this process, the flap is returned to its original position.
LASIK (laser in situ keratomileusis) for vision correction is considered investigational.
Any specific products referenced in this policy are just examples and are intended for illustrative purposes only. It is not intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available. These examples are contained in the parenthetical e.g. statement.
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
American Academy of Ophthalmology. (2017). Preferred Practice Pattern® refractive errors & refractive surgery. Retrieved December 6, 2018 from http://www.aao.org.
National Institute for Health and Clinical Excellence. (2006, March). Photorefractive (laser) surgery for the correction of refractive errors. Retrieved June 26, 2015 from http://www.nice.org.
ORIGINAL EFFECTIVE DATE: 5/1998
MOST RECENT REVIEW DATE: 1/10/2019
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
This document has been classified as public information.