Key facts for NCD 80.8
- Benefit category
- Diagnostic Tests (other)
- Effective date
- 08/31/1992
- Transmittal
- Transmittal 61
- Versions published
- 1
- Manual chapter
- 80
- NCD Manual (Pub. 100-03)
TL;DR
NCD 80.8 sets Medicare's national policy for endothelial cell photography under the benefit category "Diagnostic Tests (other)", effective 08/31/1992. Endothelial cell photography is a covered procedure under Medicare when reasonable and necessary for patients who meet one or more of the following criteria: It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
Endothelial cell photography involves the use of a specular microscope to determine the endothelial cell count. It is used by ophthalmologists as a predictor of success of ocular surgery or certain other ocular procedures.
Indications and limitations of coverage
Endothelial cell photography is a covered procedure under Medicare when reasonable and necessary for patients who meet one or more of the following criteria:
• Have slit lamp evidence of endothelial dystrophy (cornea guttata),
• Have slit lamp evidence of corneal edema (unilateral or bilateral),
• Are about to undergo a secondary intraocular lens implantation,
• Have had previous intraocular surgery and require cataract surgery,
• Are about to undergo a surgical procedure associated with a higher risk to corneal endothelium; i.e., phacoemulsification, or refractive surgery (see §80.7 for excluded refractive procedures),
• With evidence of posterior polymorphous dystrophy of the cornea or irido-corneal-endothelium syndrome, or
• Are about to be fitted with extended wear contact lenses after intraocular surgery.
When a pre-surgical examination for cataract surgery is performed and the conditions of this section are met, if the only visual problem is cataracts, endothelial cell photography is covered as part of the presurgical comprehensive eye examination or combination brief/intermediate examination provided prior to cataract surgery, and not in addition to it. (See §10.1 .)
Text reproduced from the CMS Medicare Coverage Database record for NCD 80.8 version 1. View the original on cms.gov.
Revision history
08/1992 - Stipulated that endothelial cell photography subject to the limitation on coverage of visual tests prior to cataract surgery. Effective date 08/31/1992. (TN 61)
How this NCD shows up on remittances
A service denied under a National Coverage Determination returns CARC 50 (not deemed medically necessary) with remark N386 (decision based on an NCD); a denial citing a local policy instead carries N115. Because NCDs bind nationally, the appeal path is documentation that the patient meets the indications above, not a contractor-policy argument.
How QuickIntell applies NCD 80.8
QuickAuth checks the ordered service and diagnosis against NCD and LCD criteria before the encounter, QuickCode validates the diagnosis pairing on the claim, and QuickRCM routes CARC 50 denials with the policy text and the covered-code list attached so the appeal starts with evidence.
Frequently asked questions — NCD 80.8
What does NCD 80.8 cover?
Endothelial cell photography is a covered procedure under Medicare when reasonable and necessary for patients who meet one or more of the following criteria: The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 80.8 take effect?
The current version (1) is effective 08/31/1992, published in transmittal 61. This is the only published version.
Does a Local Coverage Determination override NCD 80.8?
No. A National Coverage Determination binds all Medicare Administrative Contractors; an LCD can only address services or circumstances the NCD leaves open. Claims denied under this NCD typically return CARC 50 with remark N386 (NCD) rather than N115 (LCD).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.
- Medicare Coverage Database NCDs via the CMS Coverage APIVersion API snapshot 2026-09-27 · effective 2026-09-20 · file national-coverage-ncd.jsonSHA-256 a90fadfd264b9ef4…
Disclaimer
This page reproduces the CMS National Coverage Determination text and, for laboratory NCDs, the CMS ICD-10 edit lists, as an operational reference. Coverage decisions depend on the full policy, the claim and the contractor; nothing here is legal, clinical or billing advice. CPT codes are shown as numbers only; CPT descriptors are copyright AMA.