Optical Coherence Tomography of the Head and Neck (CPB 0928, reviewed 2025-12-30)
Summary
Optical coherence tomography (OCT) of the head and neck is considered experimental, investigational or unproven for these uses because their effectiveness has not been established: annual OCT follow-up of thyroid ophthalmopathy after orbital decompression, dynamic OCT for actinic keratosis, endoscopic OCT for tympanoplasty, intra-operative wide-field OCT for deep margins in head and neck surgery, OCT for the middle ear, OCT for diagnosis of oral cancerous lesions, OCT for evaluation of voice disorders, OCT for monitoring radiation-induced skin changes in head and neck cancer, OCT angiography for detecting subclinical low perfusion in giant cell arteritis without manifest ocular involvement and in thyroid-associated ophthalmopathy, and OCT otoscopes for imaging the tympanic membrane and middle ear. CPT 0485T through 0486T, 92133 and 92134 are listed as not covered for the indications in this policy, and so are ICD-10 codes for head and neck cancer, thyroid eye disease, tympanic membrane and middle ear disorders, actinic keratosis, radiation-induced skin changes, giant cell arteritis, voice and resonance disorders, and oral cavity cancer screening.
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