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Home » Questions And Answers » Why is Corneal Collagen Crosslinking (0402T) not covered by BCBSIL even though it is FDA approved and covered under other BCBS state plans?

Why is Corneal Collagen Crosslinking (0402T) not covered by BCBSIL even though it is FDA approved and covered under other BCBS state plans?

JonScruggs
over 6 years ago

Apparently this procedure is deemed "experimental" according to the BCBSIL agent I spoke to. It's been FDA approved since May 2016, and is covered by at least eight other BCBS plans,

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Would BCBSIL rather pay for a much more expensive corneal transplant instead? Why are other BCBS plans covering this and IL does not?

Parents Reply
  • 0 over 5 years ago in reply to BCBSIL Connect Team
    I keep seeing on various Keratoconus sites that BCBS/IL covers Corneal Collagen Cross Linking. Why is it that they are showing BCBS IL covers it if it is not a covered procedure? Better still, It is FDA approved for over 2 years now and has been shown to halt progression of this eye disease so why wouldn't it be covered? If in the early stages KC gets stopped it would save insurance companies a boatload of fees for specialty fittings for contact lenses which would be considered medically necessary. Also, in people with KC who are progressing if it gets halted it could spare them a more serious procedure like a corneal transplant. Not sure of the logistics of denying a procedure that could potentially save thousands of dollars.
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