Your doctor may recommend an amniotic membrane when examination demonstrates that the surface of your eye is significantly injured, inflamed, compromised, or not healing normally.
During the evaluation, your doctor may consider the amount and location of corneal staining, whether an epithelial defect is present, the size and depth of the defect, corneal sensation, tear-film stability, severity of inflammation, corneal thinning or ulceration, previous treatments, response to treatment, duration of the abnormality, and risk of scarring or further tissue damage.
“Amniotic membrane therapy is generally not recommended simply because an eye feels dry. It becomes particularly important when there is objective evidence of significant ocular-surface injury or impaired healing.”
Insurance Coverage and Medical Necessity: Amniotic membrane treatment may be covered by Medicare or commercial insurance when applicable medical-necessity requirements are satisfied. Coverage varies according to diagnosis, severity of disease, objective clinical findings, previous treatments, individual insurance benefits, and payer policy. Prior authorization or verification of benefits does not guarantee payment. When possible, our office will review applicable benefits and expected patient financial responsibility before treatment.