CPT 92100, in plain terms, covers Repeated eye pressure measurements over several hours of one day to see how glaucoma-related pressure varies, with a report. CPT 92100 is referenced in 5 tracked payer policy changes from Aetna Better Health of Virginia and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 92100 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 92100 on AAPC
Aetna Better Health of Virginia is correcting an error that caused claims to be wrongly denied when E&M services were billed together with specific ophthalmological procedure codes. The payer has removed these codes from the denial trigger list retroactively to July 1, 2025, and will automatically reprocess all affected claims after system updates are complete by February 1, 2026.
Aetna considers computerized visual field examination, gonioscopy, measurement of the optic nerve head and retinal nerve fiber layer, pachymetry and tonometry medically necessary for evaluation of primary open-angle glaucoma. Aetna considers the following experimental, investigational or unproven: artificial intelligence-based detection of glaucoma, continuous monitoring of intra-ocular pressure, genotyping and genetic testing for glaucoma, home-based perimetry, home tonometry such as the Icare Home Tonometer, measurement of corneal hysteresis, ocular blood flow analyzers and tonometers, provocative tests, rapid campimetry, the RETeval portable electroretinogram device, and visual evoked potential testing. The listed CPT codes are covered when selection criteria are met, and ICD-10 codes H40.1110 through H40.1194 for primary open-angle glaucoma are covered when selection criteria are met.
Aetna considers computerized visual field examination, gonioscopy, measurement of the optic nerve head and retinal nerve fiber layer, pachymetry, and tonometry medically necessary for evaluation of primary open-angle glaucoma. Aetna considers artificial intelligence-based glaucoma detection, continuous intraocular pressure monitoring, glaucoma genetic testing, home-based perimetry, home tonometry such as the Icare Home Tonometer, corneal hysteresis measurement, ocular blood flow analyzers, provocative tests, rapid campimetry, the RETeval device, and visual evoked potentials experimental, investigational, or unproven. CPT codes 76514, 92020, 92081, 92082, 92083, 92100, 92133 and 92134 are covered if selection criteria are met, and CPT codes 0198T, 0329T, 0464T, 0509T, 92145, 92273, 92274, 99453, 99454 and 99457 are not covered for the indications listed.
Aetna considers ultrasound corneal pachymetry (CPT 76514) medically necessary for listed indications, including keratoconus, Fuchs' endothelial dystrophy, corneal edema, bullous keratopathy, corneal transplant and corneal refractive surgery evaluations, narrow angles, and glaucoma or glaucoma suspects, with the glaucoma indication covered once per lifetime. Repeat pachymetry for corneal diseases and injuries is not medically necessary if performed more frequently than once every 6 months. Screening for glaucoma without signs or symptoms, diagnosis of Marfan syndrome, pterygium management and monitoring on hydroxychloroquine are listed as experimental, investigational or unproven.
This is Aetna's clinical policy bulletin on ultrasound corneal pachymetry (corneal thickness measurement), CPB 0681, last reviewed October 26, 2026. It lists the indications where the test is considered medically necessary, the uses Aetna considers experimental, and a limit of one repeat test every six months for corneal diseases and injuries. The text does not describe a new rule with a stated effective date, so treat it as current policy language and confirm with Aetna before relying on it.
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