ModifiedUnitedHealthcarePolicy N/A

Corneal Topography

Policy governing medical necessity and coverage criteria for computerized corneal topography (CPT 92025) including indications, limitations, and applicable diagnosis codes for UnitedHealthcare members. Affects providers ordering or performing corneal topography and claims reviewers.

Policy Summary

PayerUnitedHealthcare

PolicyCorneal Topography

Policy CodePolicy N/A

Change TypeICD-10 code added

Effective DateOctober 1, 2025

Next Review DateN/A

Key ActionProviders must ensure clinical documentation supports one of the listed indications and follow member-specific prior authorization requirements (CPT 92025) when applicable.

SourceLink

POLICY UPDATE CHANGES

Applicable ICD-10 diagnosis code H18.591 was added to the policy.

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

Updated list of documents available in the Medicare Coverage Database.

92025CPT code listed for corneal topography

9+Example ICD-10 codes listed (partial)

2025-10-01Effective date

2025-09-10Last review

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Coverage Criteria

Indications (Covered)

Covered when ANY of the following indications are present:

Indications list: Monocular diplopia

From policy Indications.

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

Threshold specified in policy.

Indications list: Diagnosis of early keratoconus

From policy Indications.

Indications list: Suspected irregular astigmatism based on retinoscopic streak or conventional keratometry

From policy Indications.

Indications list: Post-surgical or post-traumatic irregular astigmatism

From policy Indications.

Indications list: Post-penetrating keratoplasty surgery

From policy Indications.

Indications list: Corneal dystrophies

From policy Indications.

Indications list: Post-traumatic corneal scarring

From policy Indications.

Indications list: Complications of transplanted cornea

From policy Indications.

Indications list: Pterygium and/or corneal ectasia that cause visual impairment

From policy Indications.

Indications list: Pre-operative cataract patient with documented irregular astigmatism

From policy Indications.

Clinical Indications

Covered when aligned with clinical indications and member-specific benefit plan:

Clinical indications supported by cited guidance: Use of corneal topography/tomography is supported for diagnosis and monitoring of corneal ectatic disease (e.g., keratoconus), detection and tracking of regular and irregular astigmatism, preoperative assessment for cataract surgery with significant astigmatism (including IOL selection and surgical planning), assessment after corneal transplant (including suture management), evaluation of pterygium or other corneal surface growths affecting vision, and assessment of post-surgical or post-traumatic corneal irregularities.

Based on AAO preferred practice patterns and NICE guidance cited in policy.

Pre- or post-operative corneal topography performed in relation to a Medicare non-covered procedure is not covered.

Corneal topography performed for screening purposes or without associated signs, symptoms, illness, or injury listed in the indications is not covered (non‑covered / not medically necessary).

Coverage for corneal topography is subject to the member-specific benefit plan. The benefit plan document identifies covered, excluded, and limited services; in the event of a conflict, the member-specific benefit plan document supersedes this policy.

Services performed for screening purposes or in the absence of associated signs, symptoms, illness, or injury listed in the indications are non-covered (not medically necessary) and may be denied.

This excerpt does not list additional explicit conditions labeled “not medically necessary.” Providers must continue to follow the member-specific benefit plan 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 Codes (examples, 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
H16.301	Unspecified interstitial keratitis, right eye
H17.9	Unspecified corneal scar and opacity
H18.601	Keratoconus, unspecified, right eye
H18.602	Keratoconus, unspecified, left eye
H18.603	Keratoconus, unspecified, bilateral
H18.511	Endothelial corneal dystrophy, right eye
H18.512	Endothelial corneal dystrophy, left eye

1–10 of 13

1/2

Other Diagnosis / Status Codes (historical ICD-9 listings shown)mixed

294.7	Corneal transplant status
298.41	Cataract extraction status, right eye
298.42	Cataract extraction status, left eye

Applicable ICD-10 CodesICD-10

H18.591

Specified ICD-10 diagnosis code added to policy

Post-surgical or post-traumatic astigmatism threshold

Post-surgical/post-traumatic astigmatism threshold>= 3.5 diopters

Context of thresholdListed among covered indications for corneal topography when documenting post-surgical or post-traumatic astigmatism

Documentation requirementClinical documentation must support measurement of astigmatism at or above this threshold to meet coverage indication

Astigmatism threshold in cited study

Study astigmatism threshold> 3.5 D

Study context

Provider Actions / Documentation Requirements

Prior Authorization

Procedure code and authorization note

Procedure code referenced for this service is CPT 92025 (computerized corneal topography, unilateral or bilateral, with interpretation and report). Prior authorization requirements, if any, are determined by the member-specific benefit plan and any applicable UnitedHealthcare Medicare Advantage delegate. Providers should verify and obtain any required prior authorization before performing the service.

Affected code: CPT 92025 — Computerized corneal topography, unilateral or bilateral, with interpretation and report

Prior Authorization

Follow delegated authorization requirements

When a delegate manages utilization management and authorization requirements for a UnitedHealthcare Medicare Advantage plan, providers must follow the delegate's authorization and utilization policies and procedures in addition to UnitedHealthcare requirements. Verify delegate-specific prior authorization portals, submission processes, and timelines prior to service.

Follow delegate authorization requirements when applicable
Confirm submission portal and documentation requirements with the delegate

Background

Corneal topography is a computer-assisted imaging method that maps the anterior corneal surface and detects subtle surface irregularities and astigmatism. It is used to detect corneal ectasia and monitor progression of ectatic disorders (for example, keratoconus), assess changes after procedures such as pterygium excision or corneal transplant, and assist preoperative assessment when irregular astigmatism is present.

Definitions

Corneal topography

DefinitionComputerized corneal topography: instrument projects a series of light rings on the cornea to create a color-coded map and a cross-sectional profile of the corneal surface.

Primary useProvides detailed map/chart of the anterior corneal surface to detect subtle surface irregularity and astigmatism.

OutputColor-coded topographic map and cross-section profile representing corneal curvature and shape.

Clinical importanceAllows accurate portrayal of corneal physical state for diagnosis and surgical planning.

Corneal tomography / advanced corneal imaging

DefinitionCorneal tomography/advanced corneal imaging: technologies that add diagnostic capability beyond topography by assessing overall corneal shape, including both anterior and posterior surfaces and full pachymetric mapping.