C1818 Integrated keratoprosthesis

Integrated keratoprosthesis

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for C1818

Payer coverage policies that name C1818

C1818 appears in 6 coverage policies from Aetna, Blue Shield of California, BlueCross BlueShield of South Carolina, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaCorneal Remodeling (0023)covered if criteria are metOct 9, 2026payer document
AetnaCritical Flicker Fusion (0860)listed, no stanceDec 24, 2025payer document
Blue Shield of California| Keratoprosthesis (9.03.01)listed, no stancepayer document
BlueCross BlueShield of South CarolinaKeratoprosthesis (CAM 90301)listed, no stanceJan 1, 2026payer document
Capital Blue CrossKeratoprosthesis and Corneal Surgery (Formerly Corneal Surgery) (MP 9.011)
Procedure Codes
covered if criteria are metSep 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Keratoprosthesis (OTH903.030)listed, no stanceSep 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • KY: $0.00 (asc), effective Jan 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.