AetnaAll Plans · Coverage · Medical Policy · OphthalmologyMedium impact
Artificial Retina and Artificial Iris (CPB 0713, reviewed 2026-10-15)
Effective date
Not stated in the notice
Identified
Oct 23, 2026
Summary
Aetna considers artificial retina devices, such as the Argus II, and artificial iris devices, such as the CustomFlex Artificial Iris, experimental, investigational, or unproven because their effectiveness has not been established. The CPT, HCPCS and ICD-10 codes listed in the policy are not covered for the indications listed in the policy, which include anterior segment reconstruction, aniridia, post-operative or traumatic aphakia and other iris defects. The policy states that there is insufficient evidence that artificial retina devices result in improved useful vision, and that the available evidence on artificial iris use for aniridia is weak.
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01Billing team: Do not bill the listed CPT, HCPCS and ICD-10 codes for the indications listed in this policy, because they are not covered for those indications.
02Billing team: Do not bill artificial retina or artificial iris devices for the uses listed in this policy, because Aetna considers them experimental, investigational, or unproven.
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