ModifiedUnitedHealthcarePolicy MMP062.14

Corneal Topography

Defines medical necessity, limitations, and applicable coding for computerized corneal topography (CPT 92025) for UnitedHealthcare members; applies to providers performing/ordering corneal topography and claims adjudicators.

Policy Summary

PayerUnitedHealthcare

PolicyCorneal Topography

Policy CodePolicy MMP062.14

Change TypeAdded ICD-10 codeupdated evidence/references

Effective DateOct 1, 2025

Next Review DateN/A

Key ActionObtain prior authorization when required by the member's benefit plan or applicable LCD/LCA for CPT 92025.

SourceLink

POLICY UPDATE CHANGES

Added ICD-10 diagnosis code H18.591 to applicable codes.

Updated Clinical Evidence and References sections to reflect the most current information.

92025CPT code listed

11+ICD-10 codes (partial list)

10Indications enumerated

LCDs existMedicare LCDs referenced

AAO 2023/2024AAO guidance cited

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Coverage Criteria

Medically Necessary Indications

Covered when ANY of the following indications are present:

Indications for corneal topography: Pre-operative evaluation of irregular astigmatism for intraocular lens power determination with cataract surgery

For pre-operative cataract patients, irregular astigmatism must be documented.

Monocular diplopia

Diagnosis of early keratoconus

Post-surgical or post-traumatic astigmatism, measuring at a minimum of 3.5 diopters>= 3.5 diopters

Suspected irregular astigmatism based on retinoscopic streak or conventional keratometry

Post-penetrating keratoplasty surgery

Post-surgical or post-traumatic irregular astigmatism

Corneal dystrophies

Complications of transplanted cornea

Post-traumatic corneal scarring

Pterygium and/or corneal ectasia that cause visual impairment

Indications supported by evidence/guidelines

Supportive guidance from specialty societies and national guidelines informs clinical utility in specific scenarios

Guideline-supported uses: AAO: Topography/tomography is central to diagnosis and follow-up of corneal ectatic disease and useful for assessing anterior and posterior surfaces and pachymetry; AAO notes topography may aid in diagnosis of post-operative irregular corneal astigmatism and is used for keratoconus, post-surgical astigmatism, surgical planning, and assessment of effects of pterygium and corneal scars.

References: AAO preferred practice patterns (Corneal Ectasia 2023; Cataract 2021) and AAO EyeWiki/EyeSmart summaries.

NICE guidance: NICE: In cataract surgery management, consider corneal topography for preoperative assessment when significant astigmatism is present.

Reference: NICE Cataracts in adults: management (2017).

Services performed for screening purposes or in the absence of associated signs, symptoms, illness, or injury as indicated in this policy are non-covered. Corneal topography performed solely for screening without a documented clinical indication, or when performed in relation to a Medicare non-covered procedure (for example, radial keratotomy), is not covered and may be denied.

This policy is provided as guidance to support UnitedHealthcare coverage decisions but does not replace the member's benefit plan document. Benefit coverage for health services is determined by the member-specific benefit plan document and applicable laws, and in the event of a conflict the member's benefit plan supersedes this policy. For questions about a specific member's coverage or prior authorization requirements, providers should refer to the member's plan documents or contact the customer service number on the back of the member ID card.

Corneal topography performed for routine screening or when no supporting clinical signs, symptoms, illness, or injury are documented is considered not medically necessary/non-covered. Additionally, corneal topography is not covered when performed pre- or post-operatively in relation to a Medicare non-covered procedure (e.g., radial keratotomy).

No separate explicit "not medically necessary" policy statements beyond the coverage limitations and exclusions appear in this segment; providers should use the stated limitations and the member's benefit plan to determine coverage and retain documentation to support medical necessity when requested.

Coding

Applicable CPT CodesCPTCovered

92025

Computerized corneal topography, unilateral or bilateral, with interpretation and report.

Applicable ICD-10 Diagnosis Codes (partial list)ICD-10

H11.001	Unspecified pterygium of right eye.
H11.002	Unspecified pterygium of left eye.
H11.003	Unspecified pterygium of eye, bilateral.
H11.011	Amyloid pterygium of right eye.
H11.012	Amyloid pterygium of left eye.
H11.013	Amyloid pterygium of eye, bilateral.
H11.021	Central pterygium of right eye.
H11.022	Central pterygium of left eye.
H11.023	Central pterygium of eye, bilateral.
H11.031	Double pterygium of right eye.

1–10 of 91

1/10

Added ICD-10 diagnosis codesICD-10

H18.591

Other hereditary corneal dystrophies, right eye.

Coding guidance notemixed

affected codes

Policy references CPT/CMS coding guidelines for corneal topography procedures; specific CPT/HCPCS codes listed elsewhere in the full policy.

Provider Actions & Requirements

Prior Authorization

Prior Authorization Required for CPT 92025

Prior authorization may be required for CPT 92025 when mandated by the member's plan, an applicable LCD/LCA, or a delegated entity. Verify prior authorization requirements with the member-specific benefit plan, the local coverage determination, and any delegated utilization management contractor before scheduling the service.

Affected code: CPT 92025 (Computerized corneal topography, unilateral or bilateral, with interpretation and report)
Check plan-level prior authorization rules and any applicable LCD/LCA
Follow delegate/contractor prior authorization processes when applicable

Prior Authorization

Prior Authorization Requirement

Prior authorization requirements vary by plan and by delegated entity. Providers must follow the prior authorization rules of the member's specific UnitedHealthcare Medicare Advantage plan or the requirements of any delegated utilization management organization.

Confirm whether the member's plan or a delegated contractor requires prior authorization

Background

Corneal topography is a computerized diagnostic imaging technique that generates a detailed map of the anterior corneal surface to detect surface irregularity, astigmatism, and changes from disease or surgery. It is used to assist in diagnosis and monitoring of conditions such as keratoconus, corneal ectasia and dystrophies, assessment of post-surgical or post-traumatic corneal changes, and in pre-operative evaluation for intraocular lens selection and management of irregular astigmatism.

Definitions

Corneal topography (92025) — definition

DefinitionComputerized corneal topography (CPT 92025) is a computer-assisted diagnostic imaging technique in which a special instrument projects a series of light rings onto the cornea to create a color-coded map and a cross-sectional profile of the anterior corneal surface, depicting surface shape and irregularities.

Primary purposeProvides a detailed map/chart of the physical features and shape of the anterior corneal surface to detect subtle surface irregularity and astigmatism.

OutputColor-coded corneal surface map plus cross-sectional profile (keratometry/shape data) used for clinical assessment and surgical planning.

Clinical utility examplesAids detection of irregular astigmatism, evaluation for keratoconus, and preoperative assessment for intraocular lens selection.

Corneal topography and tomography — definitions and distinctions