Summary
Blue Cross Blue Shield Association policy 9.03.22, now listed as BCBSMS policy L.9.03.412, states that endothelial keratoplasty (Descemet stripping endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty, Descemet membrane endothelial keratoplasty, or Descemet membrane automated endothelial keratoplasty) may be considered medically necessary for endothelial dysfunction, including ruptures in Descemet membrane, endothelial dystrophy, aphakic and pseudophakic bullous keratopathy, iridocorneal endothelial syndrome, corneal edema attributed to endothelial failure, and failure or rejection of a previous corneal transplant. Femtosecond laser-assisted endothelial keratoplasty and femtosecond and excimer laser-assisted endothelial keratoplasty are considered investigational, and endothelial keratoplasty is considered investigational when endothelial dysfunction is not the primary cause of decreased corneal clarity. The most recent policy update, dated 03/11/2026, removed ICD-9 diagnosis codes from the policy.
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