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Corneal Pachymetry (CPB 0681, reviewed 2026-10-26)
Effective date
Not stated in the notice
Identified
Nov 3, 2026
Previous versions
- Corneal Pachymetry (CPB 0681, reviewed 2025-10-15) · published Oct 15, 2025
Summary
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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What to do
Action · 8 steps
01No change with a source-stated effective date is identified in this bulletin.
02The 'Effective 01/02/2004' line is the policy's original date, and the 10/26/2026 review date is not an effective date.
03Ophthalmology and optometry billing team: before billing CPT 76514 (ultrasound corneal pachymetry), confirm the chart documents one of the listed indications: anatomical narrow angles, bullous keratopathy, corneal edema, corneal refractive surgery pre- or post-operative evaluation, corneal transplant (penetrating keratoplasty) pre- or post-operative evaluation, a single evaluation of complications of refractive surgery, corneal rejection after penetrating keratoplasty, Fuchs' endothelial dystrophy, keratoconus, recent laser iridotomy, glaucoma or glaucoma suspect (once per lifetime), or posterior polymorphous dystrophy.
04For corneal diseases and injuries, do not schedule or bill repeat testing more often than once every six months.
05Do not bill for glaucoma screening in people without signs or symptoms of glaucoma, pre-cataract testing without documented corneal disease, testing to predict success of an artificial endothelial layer (EndoART) implant, or the other experimental uses listed in the bulletin, since Aetna considers them experimental, investigational or unproven.
06Front desk and billing: for members whose plans exclude refractive surgery, pachymetry for refractive surgery evaluation is excluded, so check the benefit plan description first.
07Verify before billing: the bulletin lists keratoconus (H18.601 to H18.629) as a medically necessary indication, but the same bulletin also lists those codes under codes not covered for the listed indications.
08Confirm with Aetna how keratoconus claims should be coded before relying on either list.
Codes mentioned
765146683066984657106577565820667619202092100G0117G0118S0800S0810S0812H18.10H18.239H18.511H18.519H18.591H18.599H40.001H40.1394H40.151H47.231H47.239Q15.0T86.8401T86.8409Z94.7B50.0B54H11.001H11.069H15.121H15.129H16.251H16.259H18.451H18.459H18.461H18.469H18.531H18.539H18.601H18.629H25.011H26.9H28H40.1410H40.1494M05.40M06.9M32.0Q12.0Q87.40Q87.43Z13.5
Original notice
Corneal Pachymetry (CPB 0681, reviewed 2026-10-26)
aetna.com · Always check the source before changing claims.
Related changes
See all Aetna changes →Corneal Pachymetry (CPB 0681, reviewed 2025-10-15)MediumNo effective date · Medical PolicyComputerized Corneal Topography (CPB 0130, reviewed 2026-03-26)MediumNo effective date · Medical PolicyEndothelial Cell Photography (CPB 0538, reviewed 2026-08-26)MediumNo effective date · Medical PolicyCorneal Graft and Amniotic Membrane Transplantation, Corneal Stromal Lenticule Transplantation, Limbal Stem Cell Transplantation, or Sural Nerve Grafting for Ocular Indications (CPB 0293, reviewed 2026-06-08)MediumNo effective date · Medical PolicyBrowse every Aetna change in the policy list
Related policy hubs
Aetna policiesOphthalmologyOptometryCode 76514Code 66830Code 66984Code 65710Code 65775Code 65820Code 66761Code 92020Code 92100Code G0117Code G0118Code S0800Code S0810Code S0812Code H18.10Code H18.239Code H18.511Code H18.519Code H18.591Code H18.599Code H40.001Code H40.1394Code H40.151Code H47.231Code H47.239Code Q15.0Code T86.8401Code T86.8409Code Z94.7Code B50.0Code B54Code H11.001Code H11.069Code H15.121Code H15.129Code H16.251Code H16.259Code H18.451Code H18.459Code H18.461Code H18.469Code H18.531Code H18.539Code H18.601Code H18.629Code H25.011Code H26.9Code H28Code H40.1410Code H40.1494Code M05.40Code M06.9Code M32.0Code Q12.0Code Q87.40Code Q87.43Code Z13.5