January 1, 2022

Health Frist Health Plans- Florida has announced that Optometrist are now able to bill CPT Code 83861, tear osmolarity, as a covered service effective date of January 1, 2022. Ophthalmology continues to be a covered specialty with no changes.  If there are any additional questions, please contact the TearLab Reimbursement Support Center.

May 26th, 2021

Unicare of West Virginia has announced that CPT CODE 83861, tear osmolarity test, will be added to the new Physician Office List (POL) effective May 26^th, 2021.  Claims will be retroactively paid.   If there are questions, please contact the TearLab Reimbursement Support Center.

April 15, 2021

Georgia Blue Cross Blue Shield Georgia revised their HMO Stat Lab List for tear osmolarity testing, and effective 04/15/2021 tear osmolarity testing for patients suspected of dry eye disease will be covered and paid as Medically Necessary. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

January 1, 2021

Capital Blue revised their non-coverage Medical Policy for tear osmolarity testing, and effective 1/1/2021 tear osmolarity testing for patients suspected of dry eye disease will be covered and paid as Medically Necessary. If there are any additional questions, please contact the Tearlab Reimbursement Support Center.

December 1, 2020-Kansas City

Blue Cross Blue Shield Kansas City revised their non-coverage Medical Policy for tear osmolarity testing, and effective 12/1/2020 tear osmolarity testing for patients suspected of dry eye disease will be covered and paid as Medically Necessary. If there are any additional questions, please contact the Tearlab Reimbursement Support Center.

November 10, 2020- North Carolina

Blue Cross Blue Shield North Carolina revised their non-coverage Medical Policy for tear osmolarity testing, and effective 11/10/2020 tear osmolarity testing for patients suspected of dry eye disease will be covered and paid as Medically Necessary. If there are any additional questions, please contact the Tearlab Reimbursement Support Center.

October 1, 2020- South Carolina

Blue Cross Blue Shield South Carolina revised their non-coverage Medical Policy for tear osmolarity testing, and effective 10/1/2020 tear osmolarity testing for patients suspected of dry eye disease will be covered and paid as Medically Necessary. If there are any additional questions, please contact the Tearlab Reimbursement Support Center.

June 25, 2020- Florida,

Puerto Rico, Virgin Islands First Coast retired (LCD) Local Coverage Determination for the Diagnostic Evaluation and Medical Management of Moderate- Severe Dry Eye Disease (DED) (L36232). Effective 6/25/2020 any limitation in the LCD on tear osmolarity testing is removed, and coverage is determined for patients suspected of or being actively managed for dry eye disease as supported by Medical Necessity. For additional information on proper documentation to support Medical Necessity, or if there are any additional questions, please contact the Tearlab Reimbursement Support Center.

June 28, 2019 - Texas

Molina Healthcare Texas, effective January 1, 2019, established coverage for the tear osmolarity test, CPT code 83861, for the State of TX. Recently, Molina has been denying claims in error as a non-covered service (CO96). TearLab is working closely with Molina on behalf of our customers to have affected claims reprocessed for payment. To ensure that your claims are addressed properly, we suggest faxing any denied EOBs to TearLab at (817) 382-5750 and we will coordinate reprocessing with Molina on your behalf. Should you have questions, please feel free in contact  TearLab Reimbursement Support Center at RSC@tearlab.com

April 1, 2019 - Louisiana

Blue Cross Blue Shield of Louisiana has announced that effective April 1, 2019 CPT Code 83861, tear osmolarity, will be a covered service under all lines of business, including PPO, Commercial, HMO and Signature Blue. Code 83861 on one line, for 2 units of service when testing both eyes, and enter a double fee to cover payment for both eyes tested. No modifiers are required. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

September 4, 2018 - North Carolina

North Carolina Medicaid has announced that Optometrist are now able to bill CPT Code 83861, tear osmolarity, as a covered service for the Medicaid product lines with an effective date of June 1, 2018.  Ophthalmology continues to be a covered specialty with no changes.  If there are any additional questions, please contact the TearLab Reimbursement Support Center.

November 6, 2017 - Michigan

Blue Card Network of Michigan has announced that an error in its claims processing system incorrectly denied payment for CPT® Code 83861, tear osmolarity test. The error has been corrected and retroactive payment will be made automatically for Medicare Blue Plus product lines that were inappropriately denied. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

October 30, 2017 - Michigan

McLaren Health Plan of Michigan has announced that CPT® Code 83861, tear osmolarity test, will be a covered service for the Medicaid product lines with an effective date of January 1, 2017. Claims will be retroactively paid from that date. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

June 1, 2017 - Georgia

The Georgia Department of Community Health, Medical Policy Division announced on June 1, 2017 that its payment rate for the tear osmolarity test, CPT 83861, is incorrectly undervalued and an increased rate will be effective for dates of service on or after January 1. 2017. For additional information please contact the TearLab Reimbursement Support Center.

October 3, 2016 - Minnesota

BCBS of Minnesota has announced that CPT 83861, tear osmolarity test, will be a covered service for Optometrists and Ophthalmologist with an effective date of October 3, 2016. The coverage update impacts the Commercial, Managed Medicaid, and Medicare lines of business within BCBS of Minnesota. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

October 1, 2016 - New York

 MVP Health Care has established coverage for the TearLab osmolarity test, CPT 83861, effective 10/01/16. The medical policy has been updated to allow coverage for Optometrists in addition to Ophthalmologists. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

January 1, 2016 - Michigan

Priority Health of Michigan has announced that CPT® Code 83861, tear osmolarity test, will be a covered service for the Medicaid product lines with an effective date of January 1, 2016.  If there are any additional questions, please contact the TearLab Reimbursement Support Center.

November 1, 2015 - Michigan

United Heathcare (UHC) of Michigan has announced that CPT® Code 83861, tear osmolarity test, is a covered service for the Medicaid product line with an effective date of November 1, 2015.  If there are any additional questions, please contact the TearLab Reimbursement Support Center.

September 1, 2015 - Minnesota

Blue Cross Blue Shield (BCBS) of Minnesota has announced that CPT® 83861, tear osmolarity test, is a covered service for the Medicare Advantage product line with an effective date of September 1, 2015.  If there are any additional questions, please contact the TearLab Reimbursement Support Center.

August 1, 2015 - Puerto Rico

Triple-S (SSS) a provider of Medicare Managed Care in Puerto Rico has announced that effective August 2015 they will initiate coverage for CPT® 83861 (tear osmolarity).  Claims should be coded and filed in the same manner as CMS Medicare.  For more information, contact the TearLab Reimbursement Support Center.

May 1, 2015 - Kansas

KanCare of Kansas has announced that CPT 83861, tear osmolarity test, will cover services for Optometrist and Ophthalmology with an effective date of May 1, 2015. The coverage update impacts Medicaid. KanCare has contracts with three managed care organizations (MCOs) who coordinate care for members, Amerigroup of Kansas, Sunflower State Health Plan, and United HealthCare Community Plan of Kansas. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

January 1, 2015 - Nationwide

Cigna has confirmed that effective as of January 1, 2015 CPT® 83861 (tear osmolarity test) has been added to its national fee schedule.  Provider contract updates may be required for providers to receive payment for this service.  Please contact the TearLab Reimbursement Support Center for assistance with these updates. 

January 1, 2015 - Maine

MaineCare has confirmed coverage for laboratory providers and vision providers.  Contact TearLab Reimbursement Support Center for details and fee schedule information.

November 14, 2014 - Michigan

Priority Health of Michigan has announced that CPT 83861, tear osmolarity test, will be a covered service for Optometrists with an effective date of January 1, 2015. The coverage update impacts the Commercial and Medicare lines of business. If there are any additional questions, please contact the TearLab Reimbursement Support Center.                        

November 3, 2014 - Florida

Capital Health Plan has announced coverage for the tear osmolarity test, CPT 83861.  Providers of Capital Health Plan will need to submit a request to add CPT 83861 to their existing contract. Contact the TearLab Reimbursement Support Center for additional information and assistance.

October 22, 2014 - Florida

Effective January 2015, Florida Medicaid has announced that CPT 83861, tear osmolarity, will be added to the fee schedule for Optometrists. If there are additional questions, please contact TearLab for additional information.

October 1, 2014 - Georgia

Coventry of Georgia has initiated coverage for the tear osmolarity test, CPT 83861.  Providers of Coventry of Georgia will need to request an amendment to add CPT 83861 to their existing contract.  Contact TearLab Reimbursement Support Center for additional information and assistance.

July 31, 2014 - Indiana

Effective immediately, Indiana Medicaid has announced that CPT 83861, tear osmolarity, has been added to the fee schedule for Optometrists with retroactive coverage. Providers may receive payment retroactively as long as the claim is not outside the 1 year timely filing limit from date of service. If there are additional questions, please contact TearLab for additional information.

July 29, 2014 - Massachusetts

BCBS of Massachusetts has announced that CPT 83861, tear osmolarity test, will be a covered service for Optometrists with an effective date of September 1, 2014. The coverage update impacts the Commercial, Managed Medicaid, and Medicare lines of business within BCBS of Massachusetts. If there are any additional questions, please contact the TearLab Reimbursement Support Center.

May 15, 2014 – Chicago and Central IL

Advocate Health with Advocate Physician Partners (APP), a care management collaboration, has announced that CPT 83861, tear osmolarity, has been added to the fee schedule for Optometrists and Ophthalmologists with retroactive coverage starting from 10/1/2013. All previously denied claims with date of service on or after 10/1/2013 will automatically be re-processed by Advocate Health and paid. Plans offered include Commercial and Medicare HMO whom APP has benefits for members. For additional questions or information, please contact TearLab Reimbursement Support Center at rsc@tearlab.com.

April 31, 2014- Puerto Rico

Medical Card System (MCS) a provider of Managed Care, Medicare and Commercial Plans in Puerto Rico has announced that effective April 1, 2014 they will initiate coverage for CPT 83861 (tear osmolarity).  Claims should be coded and filed in the same manner as CMS Medicare. For more information, contact the TearLab Reimbursement Support Center.

April 28, 2014- Illinois

Presence Health, the largest Catholic health system based in Illinois, a combination of St. Mary’s and St. Elizabeth network, has announced coverage for CPT 83861, tear osmolarity, effective September 1, 2013. Claims with a date of service on or after this date have been adjudicated and paid. No in office lab list is required for coverage.

April 15, 2014 – Philadelphia, PA

Health Partners Plans, a Philadelphia area Managed Care Organization, has announced that CPT 83861, tear osmolarity, has been added to the fee schedule for Optometrists and Ophthalmologists with coverage starting from 4/1/2014. Health Partners Plans offers Managed Medicaid, CHiP, and Medicare Advantage benefits for members within Philadelphia and its surrounding counties. If there are additional questions, please contact TearLab for additional information.

April 10, 2014 – New Jersey

QualCare Inc., a New Jersey managed care plan is now covering CPT 83861, Tear Osmolarity within its Commercial and Medicare benefits. In order to receive payment, QualCare Inc. has advised all in-network providers to contact their Provider Relations Representative to update their contract to allow for in-office laboratory testing. If there are different contracts to cover multiple benefits, each contract would need updating. It is encouraged that when contacting Provider Relations to have all necessary CLIA information available. If there are additional questions, please contact TearLab for additional information.

March 24, 2014 - North and South Carolina

Coventry of the Carolinas, serving over 187,000 North and South Carolina residents, has advised that effective April 1, 2014, CPT 83861, tear osmolarity, will be added to the in-office lab list, allowing coverage when the test is performed in an ophthalmology or optometry office.

Effective January 6, 2014, CMS will no longer accept a Group NPI number as the Referring Physician identification (item 17 on the CMS-1500 form) for claims for laboratory services, including tear osmolarity (CPT 83861).  This requirement applies only to the Referring/Ordering provider identification.  Payments may still be made to group or organizational NPI numbers.

For details please see MLN Matters Number SE1305 Revised - MLN Matters SE1305

For all claims for a tear osmolarity test, enter the name and NPI for the ordering/referring provider, not the group NPI, in item 17 of paper claims (CMS-1500).  Name and NPI number must match.  Only include the first and last name as it appears on the “Ordering and Referral File” found here: Ordering & Referring Information CMS.gov

For electronic claims, make sure that the qualifier (X12N 837P 4010A1) 2310A NM102 loop is a 1 (person). Organizations (qualifier 2) cannot order and refer.

Please note that CPT 83861 (tear osmolarity) remains a covered service for CMS Medicare and reimburses under the CMS Clinical Laboratory Fee Schedule at $22.54 per test in 2014 which can be found on here: 14CLAB 

If you have any denials for CMS Medicare claims or need additional assistance in this matter, please contact the TearLab Reimbursement Support Center at 855-TEARLAB (1-855-832-7522), Option 1, then Option 4 or email us at rsc@tearlab.com.

February 14, 2014 - South Carolina

BlueCross BlueShield of South Carolina announced that tear osmolarity testing (CPT 83861) will now be covered when performed in a physician office for BlueChoice HealthPlan patients. Coverage will be effective from 1/1/2014.

February 7, 2014 - Virginia

Optima Health Plan, also known as Sentara Health Plans, has advised that the tear osmolarity test, CPT 83861, will be added to its approved in-office laboratory test list, allowing coverage for patients tested at their doctor's office. The effective date of coverage to be announced.

December 23,  2013 - Pennsylvania, New Jersey Delaware

Independence Blue Cross has notified the American Optometric Association and the Pennsylvania Medical Society that the tear osmolarity test, CPT 83861, will be reimbursed for optometry or ophthalmology beginning with dates of service on or after February 1, 2014. 

December 3, 2013 - New York

Capital District Physicians' Health Plan (CDPHP) which has covered the tear osmolarity test effective January 1, 2013, has today advised that its system has now been updated to accept claims for CPT 83861.  All new claims should be paid automatically when submitted.  Contact TearLab Reimbursement Support Center for advice on obtaining payment for previously submitted denied claims.

November 25, 2013 - New York

United HealthCare Oxford, covering the greater NYC metropolitan area, has announced that CPT 83861 (tear osmolarity) will be added to its allowed in-office laboratory list, with coverage for physician office laboratories effective December 1, 2013.  Note that UHC Oxford requires tear osmolarity to be billed with 83861 as one line item for 2-units of service, use no modifiers, when testing both eyes.

November 22, 2013 - Alabama

Blue Cross Blue Shield of Alabama has advised that the tear osmolarity test (CPT 83861) will be added to the allowed in-office laboratory list and to the Preferred Optometry fee schedule, with coverage retroactive to January 10, 2013.  BCBS AL will need to incorporate some changes to their system before coverage can be initiated, but all affected claims will be internally reprocessed.  Contact TearLab's Reimbursement Support Center for additional information.

November 21, 2013

Blue Cross Blue Shield of Georgia, whose laboratory fee schedule has been paying CPT 83861 (tear osmolarity) below the cost to perform the test, has agreed to match Medicare's CMS Clinical Laboratory Fee Schedule.  CMS had previously accepted a formal cost analysis that accurately reimburses the doctor for the resources necessary to perform the in-office tear osmolarity test.  For more information visit the CMS website at CMS Laboratory Fee Schedule.

November 18, 2013 - Texas

Scott & White Health Plan has announced coverage for the tear osmolarity test, CPT 83861.  Providers of Scott & White will need to submit an amendment to add CPT 83861 to their existing contract.  Contact TearLab Reimbursement Support Center for additional information and assistance.

October 30, 2013 - New York

Director of Provider Support at Blue Shield of Northeast New York has advised the American Optometric Association, Third Party Center, that the tear osmolarity test, CPT 83861, will be reimbursed when billed by an optometrist or ophthalmologist and will be paid separately from an office visit or eye examination.

October 30, 2013 - New York

Director of Provider Support at BCBS of Western New York has advised the American Optometric Association, Third Party Center, that the tear osmolarity test, CPT 83861, will be reimbursed when billed by an optometrist or ophthalmologist and will be paid separately from an office visit or eye examination.  

The Physician & Contracting Management department, at Emblem Health confirmed that the tear osmolarity test, CPT 83861, is a covered service and will be reimbursed. Some claims are being denied because Emblem Health has not entered this code into their system. Although an exact date of system implementation was not provided, it was recommended that providers continue to submit claims for 83861. If claims are denied, once a month or once a quarter they should submit a spread sheet of the denied claims to their Emblem Health provider representative for manual processing and payment. Claims will be paid retroactive to November 1, 2012 when Emblem Health initiated coverage for CPT 83861. For additional information or assistance please contact your Emblem Health provider representative or the TearLab Reimbursement Support Center.

September 1, 2013 - California

Brown & Toland Physicians, an independent practice association (IPA) of more than 850 community physicians serving 300,000 San Francisco Bay Area residents, has agreed, effective September 1, 2013, to allow tear osmolarity testing, CPT 83861, to be performed at the doctor's office. Prior to this laboratory testing was capitated to LabCorp and tear osmolarity was not allowed at the doctors office.

August 21, 2013 - Michigan

HealthPlus of Michigan has advised that CPT 83861 (tear osmolarity) has been added to its system as a covered code to automatically pay submitted claims. Prior to this a Special Office Procedure (SOP) request form needed to be submitted for payment for tear osmolarity tests. The SOP form will no longer be required.

August 1, 2013 - Ohio

The Ohio Department of Medicaid announced that CPT 83861 (tear osmolarity) will be added to its approved CLIA Waived test list. It is expected that their payment system will be upgraded with the change in the next 30-days, and the change will be retroactive. Doctors with a CLIA Waiver certificate who have been denied payment for the tear osmolarity test (CPT 83861) can resubmit their claims which will be paid retroactively.

July 17, 2013 - Hawaii

UHA, formally known as University Health Alliance, in Hawaii has announced that it will add the tear osmolarity test (CPT 83861) to optometry vision contracts, effective immediately. Previously, UHA was providing coverage to ophthalmology, but declining coverage to optometry.   Coverage was added to optometry contracts due to Hawaiian scope of practice provisions which allows diagnosis and treatment of dry eye disease.

July 15, 2013 - North Carolina

Blue Cross Blue Shield of North Carolina, whose laboratory fee schedule has been paying CPT 83861 (tear osmolarity) below the cost to perform the test, has agreed to re-contract NC providers to reflect new pricing methodology that will match Medicare's CMS Clinical Laboratory Fee Schedule.  CMS had previously accepted a formal cost analysis that accurately reimburses the doctor for the resources necessary to perform the in-office tear osmolarity test.  For more information visit the CMS website at CMS Laboratory Fee Schedule. 

July 1, 2013 - Florida

Blue Cross Blue Shield of Florida, covering over 2.6 million lives in the State of Florida, has added the tear osmolarity test, CPT 83861, to its allowed In-Office Laboratory Services.  A list of laboratory tests allowed in-office can be found on the BCBS FL website. Tests on this list are the only laboratory services eligible for payment when performed in the office by a participating BCBS FL or Health Options physician. Coverage is effective July 1, 2013, and will not pay for date of service prior to this date.

Blue Cross Blue Shield of Michigan has advised that its Medical Policy Committee has reversed its position that the tear osmolarity test (CPT 83861) is an "investigational / experimental" procedure. BCBS MI advises that its medical policy will be revised to reflect the medical criteria for coverage of the procedure, a process that will take approximately 90 days. Coverage will begin with dates of service after the effective date of the policy change. Claims for 83861 will not be covered during the transitional phase.

May 30, 2013 - Illinois

The Illinois Department of Public Aid (Medicaid) has agreed to establish coverage for the tear osmolarity test, CPT 83861,  when performed in a CLIA certified physicians office.

May 29, 2013 - Pennsylvania

After reviewing the optometry scope of practice in Pennsylvania, the University of Pittsburgh Medical Center health plan has announced that it will add CPT 83861, tear osmolarity testing, to the optometry fee schedule.  This will eliminate the need for optometrists to revise their provider contract to include coverage of this in-office laboratory test.  UPMC had previously added CPT 83861 to the ophthalmology fee schedule.

April 2, 2013 - Michigan

Physicians Health Plan of Mid-Michigan has added the tear osmolarity test (CPT 83861) to the in-office laboratory list, allowing the test to be performed at the doctor's office.  Outstanding claims that have not been paid can be faxed to the attention of Trisha Kopulos at (517) 364-8412  for payment. 

April 1, 2013 - Missouri

Blue Cross Blue Shield of Kansas City has advised that CPT 83861 has been added to the in-office laboratory list for HMO plans effective 4/1/13.  Previously denied claims should be resubmitted for payment as an "inquiry".

March 25, 2013 - Michigan

March 14, 2013 - New Mexico

March 7, 2013 - Virginia

March 7, 2013 - Florida

March 7, 2013 - Nationwide

February 14, 2013 - Pennsylvania

January 17, 2013 - Virginia

Anthem BCBS VA, a WellPoint health plan, has announced that effective January 17, 2013, the specialty of optometry will be added as a covered provider specialty for the tear osmolarity test for its Par/PPO policies. Its HealthKeepers (HMO) and HealthKeepers+ (Medicaid) policies will require pre-authorization for an out-of-network laboratory service.

January 10, 2013 - Alabama

Blue Cross and BlueShield of Alabama has announced that effective January 10, 2013, its non-coverage policy for the tear osmolarity test (CPT 83861) has been reversed and will begin coverage for this test.

January 1, 2013 - New York

Empire Blue Cross Blue Shield, a WellPoint health plan, has announced that the Physician Office Committee has added the tear osmolarity test (CPT 83861) to the allowed physician in-office laboratory list. Coverage for the test will be effective January 1, 2013.

December 28, 2012 - Kansas

BCBS of Kansas has confirmed coverage for CPT 83861, tear osmolarity test, when medically necessary.  In order to obtain payment for both eyes, provider relations has advised that CPT 83861 should be billed only once per claim with no modifiers but for 2-units of service when testing both eyes.

December 13, 2012 - New Jersey

December 13, 2012 - New York

December 4, 2012 - New York

October 24, 2012 - Wisconsin

October 22, 2012 - New York and Nationwide

Upon review of current peer-reviewed published literature and clinical guidelines, the EmblemHealth Medical Policy Subcommittee has reversed its designation of "experimental" for the tear osmolarity test (CPT 83861) and approved coverage, effective November 1, 2012.

October 22, 2012 - New York

HIP Health Plan of New York, an EmblemHealth company, has reversed its designation of "experimental" for the tear osmolarity test (CPT 83861) and approved coverage, effective November 1, 2012.

October 15, 2012 - Florida

October 1, 2012 - Pennsylvania

September 18, 2012 - Arkansas

August 1, 2012 - Pennsylvania

July 26, 2012 - KS, MO, NE, IA, MN, WI, IL, MI, IN

WPS Medicare has announced the addition of CPT 83861 (tear osmolarity) as payable for all optometrists effective retroactive to 5/1/12.  The revised policies can be found on the WPS website at the following links:

July 1, 2012 - California

June 18, 2012 - Nationwide

VSP today announced that coverage for CPT 83861, an in-office test for diagnosing dry eye disease, will be available on July 1, 2012.  CPT 83861 utilizes the TearLab® Osmolarity System to measure the osmolarity of human tears to aid in the diagnosis of dry eye disease in patients. This lab-on-a-chip technology helps improve standard of care by objectively and quantitatively testing for disease markers in tears at the point of care.  For a current list of Primary EyeCare covered codes and service requirements, refer to the Primary EyeCare Plan under Plans & Coverages in the Manuals section.

June 11, 2012 - Missouri

May 25, 2012 - Minnesota

It was reported at the WPS May 2012 Carrier Advisory Committee (CAC) meeting, that tear osmolarity testing (CPT code 83861) an allowed service for ophthalmology under its Local Coverage Determination policy will now also include Optometry.  It was stated that coverage will be effective as of May 1, 2012 in all states where WPS is the Medicare carrier, including IA, KS, MO, NE, MN, WI, IL and MI . Please note that this is not official until the coverage policy is updated on the WPS website. We will post a reimbursement update once the official notice is in effect.

May 10, 2012 – Michigan

Priority Health has confirmed that it has added both ophthalmology and optometry as specialties that qualify for coverage for tear osmolarity tests performed in doctor’s offices for the diagnosis and management of dry eye disease.  

April 18, 2012 – New York

After review of the clinical guidelines for dry eye disease and documentation demonstrating that tear osmolarity testing can only be performed at the point-of-care, CPT 83861 will be added to the list of laboratory tests that are allowed to be performed at the doctor’s office.   

April 15, 2012 – IL, TX, OK, NM

Health Care Service Corporation, the BCBS carrier for 4-states has advised that after further review by its medical policy team, it has reversed its original assessment that tear osmolarity is an “experimental/investigational procedure” and has determined that tear osmolarity is an appropriate dry eye test and intervention for the improvement of patients lives and will begin coverage effective April 15, 2012.

April 14, 2012 – Michigan

Priority Health will reimburse participating providers for 83861,“Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity", when performed in provider office laboratories if the results are needed immediately for clinical decisions.  This test is limited to tests performed by specialist physicians with a CLIA license.  

April 12, 2012 – Pennsylvania 

University of Pittsburgh Medical Center Health Plan has reviewed documentation supporting the clinical necessity of the tear osmolarity test and has agreed to cover the test. Providers must contact UPMC to update their provider contract to include coverage.  Contact TearLab Corporation for additional information. 

March 26, 2012 – Hawaii

Hawaii Medical Service Association (BCBS of HI) has approved coverage for CPT 83861 tear osmolarity test.  

March 16, 2012 – Kansas

After review of clinical and utilization documentation, including the American Academy of Ophthalmology Preferred Practice Patterns for Dry Eye Syndrome, Coventry Kansas has included CPT 83861 to its in-office laboratory tests, retroactive to January 1, 2012. 

March 15, 2012 – Virginia

After appeal by a TearLab customer for a claim not payable under the providers contract, Cigna has agreed to add CPT 83861 as allowable testing under the contract effective March 15, 2012.  

March 12, 2012 - Missouri

Coventry Health Care has added 83861 (Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity) to the list of lab codes that can be performed in the physician's office.   

March 9, 2012 – Maryland

After submission of documentation by TearLab customers to support the need to perform tear osmolarity testing at the point-of-care, Care First Blue Choice announced that CPT 83861 would be added to its allowed in-office lab list effective March 9, 2012.  

February 13, 2012 – Pennsylvania

Through intercession by Pennsylvania Optometric Association, Highmark Blue Shield has recently reversed its non-coverage policy for the tear osmolarity test, CPT 83861, when performed by an optometrist using the TearLab Osmolarity System.