ASCRS Advocates Against Anthem’s Misguided Clinical Guideline for Anesthesia During Cataract Surgery

ASCRS and Ophthalmic Community Advocate Against Anthem’s Misguided Clinical Guideline for Anesthesia During Cataract Surgery; Contact ASCRS if You Are Experiencing Coverage Denials

As we have reported, ASCRS has joined with the ophthalmic community to advocate that Anthem Blue Cross/Blue Shield revoke a recent clinical guideline that determines that anesthesia stronger than local or topical is not medically necessary. Several weeks ago, ASCRS sent a letter to Anthem requesting the guideline be rescinded since most ophthalmologists use intravenous anesthesia or sedation for cataract surgery as an addition to local or topical anesthesia. In response, Anthem has indicated that the guideline does not impact coverage decisions, and it does not intend to deny reimbursement for deeper anesthesia for cataract surgery. Despite this assurance, we continue to monitor this situation. We request any practice that experiences a denial in coverage for anesthesia services contact Allison Madson, manager of regulatory affairs, at amadson@ascrs.org or 703-591-2220. We will keep you updated.