Clinical Policy Title: Therapeutic contact lenses

Size: px
Start display at page:

Download "Clinical Policy Title: Therapeutic contact lenses"

Transcription

1 Clinical Policy Title: Therapeutic contact lenses Clinical Policy Number: Effective Date: June 1, 2014 Initial Review Date: December 18, 2013 Most Recent Review Date: January 11, 2018 Next Review Date: January 2019 Related policies: Policy contains: Hydrophilic contact lens for corneal bandage. Boston scleral lens. Scleral shell lens. Amniotic membrane transplantation. CP# CP# Corneal transplants (keratoplasty) Corneal implants ABOUT THIS POLICY: Select Health of South Carolina has developed clinical policies to assist with making coverage determinations. Select Health of South Carolina s clinical policies are based on guidelines from established industry sources, such as the Centers for Medicare & Medicaid Services (CMS), state regulatory agencies, the American Medical Association (AMA), medical specialty professional societies, and peer-reviewed professional literature. These clinical policies along with other sources, such as plan benefits and state and federal laws and regulatory requirements, including any state- or plan-specific definition of medically necessary, and the specific facts of the particular situation are considered by Select Health of South Carolina when making coverage determinations. In the event of conflict between this clinical policy and plan benefits and/or state or federal laws and/or regulatory requirements, the plan benefits and/or state and federal laws and/or regulatory requirements shall control. Select Health of South Carolina s clinical policies are for informational purposes only and not intended as medical advice or to direct treatment. Physicians and other health care providers are solely responsible for the treatment decisions for their patients. Select Health of South Carolina s clinical policies are reflective of evidence-based medicine at the time of review. As medical science evolves, Select Health of South Carolina will update its clinical policies as necessary. Select Health of South Carolina s clinical policies are not guarantees of payment. Coverage policy Select Health of South Carolina considers the use of therapeutic contact lenses to be clinically proven and, therefore, medically necessary when all of the following criteria are met (American Academy of Ophthalmology [AAO], 2017; Watson, 2012; Foulks, 2003): Use of any of the following lens types: Contact lenses or intra-ocular lenses placed after cataract surgery, as they are considered prostheses unless otherwise specified by the member s benefit plan. Hydrophilic soft contact lenses or gas-permeable fluid ventilated scleral lenses, when used in the management of severe corneal disease. Boston scleral lens when used as a moist corneal bandage if lubricants or drops are not appropriate. Scleral shell contact lenses for the treatment of severe keratoconjunctivitis sicca and/or when the orbit requires greater support because of the loss of corneal strength. Any of the following functional impairments are being corrected: Not able to achieve vision of 20/40 or better, despite best correction with eyeglasses or typical contact lenses. 1

2 Lenses will delay/prevent the need for corneal transplantation. Will improve performance of activities of daily living. Select Health of South Carolina Pennsylvania considers the use of amniotic membrane transplantation to be clinically proven and, therefore, medically necessary on a case-by-case basis for certain circumstances where there is a severe condition requiring acute treatment, such as (Zhao, 2015; Clare, 2012): Limitations: Chemical, thermal, or radiation injuries. Stevens Johnson Syndrome. Limbal stem cell failure. All other uses of therapeutic contact lenses are not medically necessary. Contact lenses for vision correction are subject to benefit plans of the individual member. The use of contact lenses for treatment of visual perceptual dysfunction, such as dyslexia, has not had consistent results in clinical studies and cannot be considered medically necessary. For Medicare members only: For services performed on or after October 1, 2015, amniotic membrane transplantation for ocular conditions will be considered medically reasonable and necessary for the following indications (L36237): Failure of standard therapy for severe ophthalmological conditions demonstrated by ocular surface cell damage or failure and/or underlying inflammation, scarring, or ulceration of the underlying stroma. There may be circumstances where there is a severe condition requiring acute treatment with amniotic membrane, such as: Chemical, thermal or radiation injuries. Stevens Johnson Syndrome. Limbal stem cell failure. Band keratopathy after treatment with other therapy, such as: Surgery. Topical medications Bandage contact lens. Patching. Bullous keratopathy associated with an epithelial defect. Scleral melting. Corneal ulcer following initiation of anti-infective therapy and demonstration of clinical response for the purpose of healing the persistent epithelial defect. Chemical burns of the ocular surface. Conjunctival defects after treatment with other therapy, such as surgery or topical medications. 2

3 Corneal melting. Limbal stem cell deficiency. Recurrent corneal erosions after treatment failure with other therapy, such as: Bandage contact lens. Patching. Topical medications. Limitations for Medicare members only: Amniotic membrane must have U.S. Food and Drug Administration (FDA) approval for sutureless applications to eye. Application for dry eye syndrome is not medically necessary, given no demonstrated impact on long-term outcome. Cogan s Dystrophy is not covered unless associated with corneal epithelial removal. Alternative covered services: Physician office visits. Standard covered ocular surgery. Standard medical management of corneal disease. Background Corneal pathology may cause correctable vision distortion, pain, or threaten sight. Vision may be corrected by the use of refractive eyeglasses or contact lenses. These lenses are primarily used for correction of myopia, hypermetropia, astigmatism, and presbyopia, and as such, are a cosmetic substitute for eyeglasses. Refracting contact lenses may be rigid/hard lens, soft (hydrophilic, hydrogel and silicone hydrogel) or gas permeable rigid lens. Therapeutic contact lenses are designed to manage other ocular pathology beyond simple refractive disorders. There are several types of therapeutic lenses available for the management of these disorders, consisting of: Corneal liquid bandage lens may be rigid gas permeable scleral contact lenses or a therapeutic contact lens. They are used to treat acute or chronic corneal disease, such as the persistent epithelial defects listed above. These lenses protect the cornea from the drying effects of air and may reduce pain and photophobia. Because such lenses cover the entire cornea with a smooth surface, they may improve vision that results from acute astigmatism. Boston scleral lens was developed through the Boston Foundation for Sight. It is a specially designed fluid-ventilated, gas-permeable contact lens. The design allows a bubble-free reservoir of oxygenated aqueous fluid to cover the corneal surface, at a neutral hydrostatic 3

4 pressure. This design makes it well suited for severe corneal diseases. Scleral shell contact lens covers the entire exposed surface of the eye. For individuals with severe dry eye, such as keratoconjunctivitis, the scleral shell lens can hold artificial tears that have been dropped into the eye. These lenses protect the eye against further drying. The scleral shell also allows support and protection when severe corneal disease has rendered the person blind. Use of the scleral shell may prevent enucleation by providing support for the rest of the eye. Amniotic membrane transplantation is performed in cases of severe thermal or chemical burns to the cornea to reduce pain and accelerate healing. Searches Select Health of South Carolina searched PubMed and the databases of: UK National Health Services Centre for Reviews and Dissemination. Agency for Healthcare Research and Quality s National Guideline Clearinghouse and other evidence-based practice centers. The Centers for Medicare & Medicaid Services (CMS). We conducted searches on November 21, Search terms were: "Contact Lenses/therapeutic use"(mesh), "Contact Lenses, Extended-Wear/therapeutic use"(mesh), therapeutic contact lenses, and amniotic membrane. We included: Systematic reviews, which pool results from multiple studies to achieve larger sample sizes and greater precision of effect estimation than in smaller primary studies. Systematic reviews use predetermined transparent methods to minimize bias, effectively treating the review as a scientific endeavor, and are thus rated highest in evidence-grading hierarchies. Guidelines based on systematic reviews. Economic analyses, such as cost-effectiveness, and benefit or utility studies (but not simple cost studies), reporting both costs and outcomes sometimes referred to as efficiency studies which also rank near the top of evidence hierarchies. Findings Most studies on the various medical uses of contact lenses have been single site, with relatively small numbers enrolled. We found no recent meta-analyses of therapeutic contact lenses or head-to-head comparisons between the various products. Reviews of studies of amniotic membrane transplantation have not found sufficient evidence from published, peer-reviewed articles to support its routine use (Clare, 2012; Hayes, 2013). Professional guidelines note the absence of such studies and recommend that the professional describe the advantages of various strategies, thus allowing the patient to be an active participant in the clinical 4

5 judgment (AAO, 2017). There is consensus that patients with corneal pathology that threatens to weaken the architecture of the eye should be treated with appropriate medical therapy and/or supporting contact lenses. The corneal disorders for which contact lenses may become therapeutic include the following conditions: Policy updates: Aphakia. Prostheses following cataract surgery. Stevens-Johnson syndrome, toxic epidermolysis necrosis, chemical burns, or other corneal stem cell deficiencies. Congenital anomalies. Neurotrophic corneas. Keratoconjunctivitis with reduced tear production. Corneal involvement of systemic autoimmune disorders. Corneal exposure disorders. Epidermal ocular disorders. Keratoconus associated with irregular astigmatism. We found one new systematic review that addressed ex vivo cultured limbal epithelial transplantation with amniotic membrane transplantation for the treatment of limbal stem cell deficiency (Zhao, 2015). We found one ongoing clinical trial of amniotic membrane transplantation that has been in progress since the year 2000, but has not been verified since 2008, and no published results of the study are available (ClinicalTrials.gov identifier: NCT ). Since the last review date of this policy, the AAO has updated three Preferred Practice Pattern guidelines: corneal edema and opacification; corneal ectasia; and dry eye syndrome (AAO, 2015a, 2015b, and 2015c). The new information does not impact the results of the original clinical policy. Therefore, no changes to the policy are warranted. In 2018, we added the results of a Cochrane review (Clearfield, 2016) and updated, consolidated guidance from the AAO (2017). Clearfield et al found that conjunctival autograft surgery was associated with a lower risk of pterygium recurrence at six months compared to amniotic membrane transplantation, but additional research is needed to determine which type of surgery resulted in better vision or quality of life. The AAO (2017) guidance has not changed. No policy changes are warranted at this time. Summary of clinical evidence: Citation AAO (2017) Content, Methods, Recommendations Key points: Summary Benchmarks for Preferred Practice Pattern Guidelines For corneal ectasia, rigid gas permeable contact lenses can mask corneal irregularities. New hybrid contact lenses provide higher oxygen permeability and greater rigid gas permeable /hydrogel junction strength. Piggyback contact lenses may be employed in cases of corneal scaring or decentered cones. Scleral lenses may be indicated when rigid gas permeable and/or hybrid contact lenses fail. 5

6 Citation Clearfield (2016) Conjunctival autograft for pterygium Cochrane review Zhao (2015) Amniotic membrane transplantation for treatment of limbal stem cell deficiency Clare (2012) Cochrane review Amniotic membrane transplantation Watson (2012) Content, Methods, Recommendations For corneal opacification, a bandage contact lens may be useful in cases of delayed healing. For corneal opacification, A rigid gas permeable lens or hybrid or scleral lens when greater stability is needed will often improve vision when surface irregularity is a factor; such lenses may preclude the need for more invasive procedures. Key points: Systematic review and meta-analysis of 20 RCTs (1,947 eyes of 1,866 total participants) from multiple countries comparing conjunctival autograft versus amniotic membrane transplantation. Overall quality: low with unclear risk of bias for most studies. In association with pterygium excision, conjunctival autograft is associated with a lower risk of recurrence after surgery than amniotic membrane transplant at 6 months (risk ratio [RR] 0.53, 95% confidence interval [CI] 0.33 to 0.85). These estimates include participants with primary and recurrent pterygia. - For participants with primary and recurrent pterygium only, RR of pterygium recurrence at 6 months' follow-up was 0.43 (95% CI 0.30 to 0.62). Insufficient evidence to assess need for repeat surgery, visual acuity outcomes, vision-related quality of life, and direct and indirect costs of surgery, or to estimate the effects of adjunctive mitomycin C on pterygium recurrence following either procedure. Adverse events associated with both procedures that occurred in more than one study were granuloma and pyogenic granuloma and increased intraocular pressure. None of the included studies reported that participants had developed induced astigmatism (13 total studies reporting). Key points: Systematic review of 18 articles involving 572 eyes of 562 patients who underwent ex vivo cultured limbal epithelial transplantation. The rate of success and 2-line improvement in best corrected visual acuity (BCVA) was 67% (95% CI 0.59 to 0.75; I = 60%) and 62% (95% CI 0.57 to 0.66; I = 37.7%), respectively; and no difference was found either in success rate (odds ratio [OR] 1.35, 95% CI 0.63 to 2.89; I = 46%) or visual acuity (VA) outcome (OR 1.53, 95% CI 0.67 to 3.45; I = 42.1%) between autograft and allograft. Cultured limbal epithelial transplantation appears efficacious in patients with limbal stem cell deficiency. Acceptable safety profile with most side effects being transient and amenable to subsequent treatments. Long-term results of autograft and allograft are needed to inform future treatment algorithms and techniques with RCTs and better-designed analysis. Key points: Systematic review found one RCT with 100 participants with ocular burns, comparing standard treatment to amniotic membrane transplantation. The study was flawed in that the control group had worse acuity at the start than did the amniotic membrane transplantation group. But the latter had better vision at the end. There is inadequate evidence supporting the treatment of ocular surface burns with amniotic membrane transplantation. Key points: 6

7 Citation Management of recurrent corneal erosion Content, Methods, Recommendations Meta-analysis of seven RCTs and one quasi-rct. These various studies came to different independent conclusions regarding use of oral tetracycline, contact lenses or hypertonic saline ointment. The therapeutic contact lens arm had older rigid lenses and was less able to reduce pain or promote healing, compared to the oral tetracycline or hypertonic saline ointment. References Professional society guidelines/other: American Academy of Ophthalmology. Preferred Practice Pattern Panels. Summary Benchmarks Full Set Jun AAO website. Accessed November 21, American Academy of Pediatrics, Section on Ophthalmology, Council on Children with Disabilities, AAO, American Association for Pediatric Ophthalmology and Strabismus and American Association of Certified Orthoptists. Learning Disabilities, Dyslexia, and Vision. Pediatrics 2009 Aug; 124(2); Also available at: Accessed November 21, Peer-reviewed references: Clare G, Suleman H, Bunce C, Dua H. Amniotic membrane transplantation for acute ocular burns. Cochrane Database Syst Rev Sep 12; 9: CD DOI: / CD pub2. Clearfield E, Muthappan V, Wang X, Kuo IC. Conjunctival autograft for pterygium. Cochrane Database Syst Rev. 2016; 2: Cd DOI: / CD pub2. Foulks GN, Harvey T, Raj CV. Therapeutic contact lenses: the role of high-dk lenses. Ophthalmol Clin North Am Sep; 16(3): Hayes Inc. Hayes Medical Technology Report. Boston Equalens Scleral Contact Lens (Polymer Technology Corp.) for Severe Ocular Surface Disease. Lansdale, Pa: Hayes Inc.; October, [Archived 2009]. Szczotka-Flynn L, Diaz M. Risk of corneal inflammatory events with silicone hydrogel and low dk hydrogel extended contact lens wear: a meta-analysis. Optom. Vis Sci Apr; 84(4): DOI: /OPX.0b013e c47. Watson SL, Lee MH, Barker NH. Interventions for recurrent corneal erosions. Cochrane Database of Sys Rev. 2012; 9: CD DOI: / CD pub3. Zhao Y, Ma L. Systematic review and meta-analysis on transplantation of ex vivo cultivated limbal epithelial stem cell on amniotic membrane in limbal stem cell deficiency. Cornea. 2015; 34(5): DOI: 7

8 /ico CMS National Coverage Determinations (NCDs): 80.1 Hydrophilic Contact Lens for Corneal Bandage. CMS website. Accessed November 21, Hydrophilic Contact Lenses. CMS website. Accessed November 21, Scleral Shell (80.5). CMS website. Accessed November 21, Local Coverage Determinations (LCDs): L36237 Amniotic Membrane- Sutureless Placement on the Ocular Surface. CMS website. Accessed November 21, L36232 Diagnostic Evaluation and Medical Management of Moderate-Severe Dry Eye Disease (DED). CMS website. Accessed November 21, Commonly submitted codes Below are the most commonly submitted codes for the service(s)/item(s) subject to this policy. This is not an exhaustive list of codes. Providers are expected to consult the appropriate coding manuals and bill accordingly. CPT Code Description Comments Fitting of contact lens for treatment of ocular surface disease Fitting of contact lens for management of keratoconus; initial fitting Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation, corneal lens, both eyes, except for aphakia Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens Prescription of optical and physical characteristics of contact lens, with medical 8

9 CPT Code Description Comments supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens ICD-10 Code Description Comments B55.2 Mucocutaneous leishmaniasis H Trichiasis without entropian right upper eyelid H Trichiasis without entropian right lower eyelid H Trichiasis without entropian right eye, unspecified eyelid H Trichiasis without entropian left upper eyelid H Trichiasis without entropian left lower eyelid H Trichiasis without entropian left eye, unspecified eyelid H Trichiasis without entropian unspecified eye, unspecified eyelid H02.89 Other specified disorders of eyelid H02.9 Unspecified disorder of eyelid H Dry eye syndrome of right lacrimal gland H Dry eye syndrome of left lacrimal gland H Dry eye syndrome of bilateral lacrimal glands H Dry eye syndrome of unspecified lacrimal gland H Primary lacrimal gland atrophy, right lacrimal gland H Primary lacrimal gland atrophy, left lacrimal gland H Primary lacrimal gland atrophy, bilateral lacrimal glands H Primary lacrimal gland atrophy, unspecified lacrimal gland H Secondary lacrimal gland atrophy, right lacrimal gland H Secondary lacrimal gland atrophy, left lacrimal gland H Secondary lacrimal gland atrophy, bilateral lacrimal glands H Secondary lacrimal gland atrophy, unspecified lacrimal gland H04.69 Other changes of lacrimal passages H Acute toxic conjunctivitis, right eye H Acute toxic conjunctivitis, left eye H Acute toxic conjunctivitis, bilateral H Acute toxic conjunctivitis, unspecified eye H10.89 Other conjunctivitis H Scarring of conjunctiva, right eye H Scarring of conjunctiva, left eye H Scarring of conjunctiva, bilateral H Scarring of conjunctiva, unspecified eye H Filamentary keratitis, right eye 9

10 ICD-10 Code Description Comments H Filamentary keratitis, left eye H Filamentary keratitis, bilateral H Filamentary keratitis, unspecified eye H Punctate keratitis, right eye H Punctate keratitis, left eye H Punctate keratitis, bilateral H Punctate keratitis, unspecified eye H Exposure keratoconjunctivitis, right eye H Exposure keratoconjunctivitis, left eye H Exposure keratoconjunctivitis, bilateral H Exposure keratoconjunctivitis, unspecified eye H Keratoconjunctivitis sicca, not specified as Sjogren's, right eye H Keratoconjunctivitis sicca, not specified as Sjogren's, left eye H Keratoconjunctivitis sicca, not specified as Sjogren's, bilateral H Keratoconjunctivitis sicca, not specified as Sjogren's, unspecified eye H Neurotrophic keratoconjunctivitis, right eye H Neurotrophic keratoconjunctivitis, left eye H Neurotrophic keratoconjunctivitis, bilateral H Neurotrophic keratoconjunctivitis, unspecified eye H Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye H Vernal keratoconjunctivitis, with limbar and corneal involvement, left eye H Vernal keratoconjunctivitis, with limbar and corneal involvement, bilateral H Vernal keratoconjunctivitis, with limbar and corneal involvement, unspecified eye H Other keratoconjunctivitis, right eye H Other keratoconjunctivitis, left eye H Other keratoconjunctivitis, bilateral H Other keratoconjunctivitis, unspecified eye H18.10 Bullous keratopathy, unspecified eye H18.11 Bullous keratopathy, right eye H18.12 Bullous keratopathy, left eye H18.13 Bullous keratopathy, bilateral H18.40 Unspecified corneal degeneration H Arcus senilis, right eye H Arcus senilis, left eye H Arcus senilis, bilateral H Arcus senilis, unspecified eye H Band keratopathy, right eye H Band keratopathy, left eye H Band keratopathy, bilateral H Band keratopathy, unspecified eye H18.43 Other calcerous corneal degeneration H Keratomalacia, right eye H Keratomalacia, left eye H Keratomalacia, bilateral H Keratomalacia, unspecified eye H Nodular corneal degeneration, right eye 10

11 ICD-10 Code Description Comments H Nodular corneal degeneration, left eye H Nodular corneal degeneration, bilateral H Nodular corneal degeneration, unspecified eye H Peripheral corneal degeneration, right eye H Peripheral corneal degeneration, left eye H Peripheral corneal degeneration, bilateral H Peripheral corneal degeneration, unspecified eye H18.49 Other corneal degeneration H18.51 Endothelial corneal dystrophy H18.53 Granular corneal dystrophy H18.54 Lattice corneal dystrophy H18.55 Macular corneal dystrophy H18.59 Other hereditary corneal dystrophies H Keratoconus, unspecified, right eye H Keratoconus, unspecified, left eye H Keratoconus, unspecified, bilateral H Keratoconus, unspecified, unspecified eye H Keratoconus, stable, right eye H Keratoconus, stable, left eye H Keratoconus, stable, bilateral H Keratoconus, stable, unspecified eye H Keratoconus, unstable, right eye H Keratoconus, unstable, left eye H Keratoconus, unstable, bilateral H Keratoconus, unstable, unspecified eye H Corneal ectasia, right eye H Corneal ectasia, left eye H Corneal ectasia, bilateral H Corneal ectasia, unspecified eye H Descemetocele, right eye H Descemetocele, left eye H Descemetocele, bilateral H Descemetocele, unspecified eye H Recurrent erosion of cornea, right eye H Recurrent erosion of cornea, left eye H Recurrent erosion of cornea, bilateral H Recurrent erosion of cornea, unspecified eye L12.1 Cicatricial pemphigoid L12.30 Acquired epidermolysis bullosa, unspecified L12.31 Epidermolysis bullosa due to drug L12.35 Other acquired epidermolysis bullosa L51.0 Nonbullous erythema multiforme L51.1 Stevens-Johnson syndrome L51.2 Toxic epidermal necrolysis [Lyell] L51.3 Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome L51.8 Other erythema multiforme L51.9 Erythema multiforme, unspecified 11

12 ICD-10 Code Description Comments M35.00 Sicca syndrome, unspecified M35.01 Sicca syndrome with keratoconjunctivitis M35.02 Sicca syndrome with lung involvement M35.03 Sicca syndrome with myopathy M35.04 Sicca syndrome with tubulo-interstitial nephropa M35.09 Sicca syndrome with other organ involvement Q10.0 Congenital ptosis Q10.1 Congenital ectropion Q10.2 Congenital entropion Q10.3 Other congenital malformations of eyelid Q10.4 Absence and agenesis of lacrimal apparatus Q10.5 Congenital stenosis and stricture of lacrimal duct Q10.6 Other congenital malformations of lacrimal apparatus S00.201A Unspecified superficial injury of right eyelid and periocular area, initial S00.202A Unspecified superficial injury of left eyelid and periocular area, initial S00.209A Unspecified superficial injury of unspecified eyelid and periocular area, initial S00.211A Abrasion of right eyelid and periocular area, initial S00.212A Abrasion of left eyelid and periocular area, initial S00.219A Abrasion of unspecified eyelid and periocular area, initial S00.221A Blister (nonthermal) of right eyelid and periocular area, initial S00.222A Blister (nonthermal) of left eyelid and periocular area, initial S00.229A Blister (nonthermal) of unspecified eyelid and periocular area, initial S00.241A External constriction of right eyelid and periocular area, initial S00.242A External constriction of left eyelid and periocular area, initial S00.249A External constriction of unspecified eyelid and periocular area, initial S00.251A Superficial foreign body of right eyelid and periocular area, initial S00.252A Superficial foreign body of left eyelid and periocular area, initial S00.259A Superficial foreign body of unspecified eyelid and periocular area, initial S00.261A Insect bite (nonvenomous) of right eyelid and periocular area, initial S00.262A Insect bite (nonvenomous) of left eyelid and periocular area, initial S00.269A Insect bite (nonvenomous) of unspecified eyelid and periocular area, initial S00.271A Other superficial bite of right eyelid and periocular area, initial S00.272A Other superficial bite of left eyelid and periocular area, initial S00.279A Other superficial bite of unspecified eyelid and periocular area, initial S05.00XA Injury of conjunctiva and corneal abrasion without foreign body, unspecified eye, initial S05.01XA Injury of conjunctiva and corneal abrasion without foreign body, right eye, initial S05.02XA Injury of conjunctiva and corneal abrasion without foreign body, left eye, initial S05.20XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, initial S05.21XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial 12

13 ICD-10 Code Description Comments S05.22XA Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, initial S05.30XA Ocular laceration without prolapse or loss of intraocular tissue, unspecified eye, initial S05.30XA Ocular laceration without prolapse or loss of intraocular tissue, unspecified eye, initial S05.31XA Ocular laceration without prolapse or loss of intraocular tissue, right eye, initial S05.32XA Ocular laceration without prolapse or loss of intraocular tissue, left eye, initial S05.50XA Penetrating wound with foreign body of unspecified eyeball, initial S05.51XA S05.52XA S05.60XA S05.61XA S05.62XA S05.70XA S05.71XA S05.72XA S05.8X1A S05.8X2A S05.8X9A S05.90XA S05.91XA S05.92XA T26.10XA T26.11XA T26.12XA T26.60XA T26.61XA T26.62XA Penetrating wound with foreign body of right eyeball, initial Penetrating wound with foreign body of left eyeball, initial Penetrating wound without foreign body of unspecified eyeball, initial Penetrating wound without foreign body of right eyeball, initial Penetrating wound without foreign body of left eyeball, initial encount Avulsion of unspecified eye, initial Avulsion of right eye, initial Avulsion of left eye, initial Other injuries of right eye and orbit, initial Other injuries of left eye and orbit, initial Other injuries of unspecified eye and orbit, initial Unspecified injury of unspecified eye and orbit, initial Unspecified injury of right eye and orbit, initial Unspecified injury of left eye and orbit, initial Burn of cornea and conjunctival sac, unspecified eye, initial Burn of cornea and conjunctival sac, right eye, initial Burn of cornea and conjunctival sac, left eye, initial Corrosion of cornea and conjunctival sac, unspecified eye, initial Corrosion of cornea and conjunctival sac, right eye, initial Corrosion of cornea and conjunctival sac, left eye, initial Z94.7 Corneal transplant status HCPCS Level II Code S0515 V2530 V2531 Description Scleral lens, liquid bandage device, per lens Contact lens, scleral, gas impermeable, per lens Contact lens, scleral, gas permeable, per lens Comments 13

Clinical Policy Title: Therapeutic contact lenses

Clinical Policy Title: Therapeutic contact lenses Clinical Policy Title: Therapeutic contact lenses Clinical Policy Number: 10.02.02 Effective Date: June 1, 2014 Initial Review Date: December 18, 2013 Most Recent Review Date: January 20, 2016 Next Review

More information

Codes for Medically Necessary Contact Lenses

Codes for Medically Necessary Contact Lenses Codes for Medically Necessary Contact Lenses CPT Codes for Medically Necessary Prescribing Preamble for the 9231X Codes The prescription of contact lenses includes specification of optical and physical

More information

ICD-10-CM Cornea. Type RT LT OU SINGLE CODE UNSPECIFIED. Acute atopic conjunctivitis H10.11 H10.12 H10.13 X H10.10

ICD-10-CM Cornea. Type RT LT OU SINGLE CODE UNSPECIFIED. Acute atopic conjunctivitis H10.11 H10.12 H10.13 X H10.10 ICD-10-CM Cornea Conjunctiva Acute atopic conjunctivitis H10.11 H10.12 H10.13 H10.10 Acute chemical conjunctivitis H10.211 H10.212 H10.213 H10.219 Acute conjunctivitis, unspecified H10.31 H10.32 H10.33

More information

Medical Affairs Policy

Medical Affairs Policy Medical Affairs Policy Service: Corneal Treatments and Specialized Contact Lenses (Corneal remodeling, Corneal transplant, Corneal collagen crosslinking, Intrastromal Rings- INTACS, Keratoconus treatments,

More information

Vision Services. Chapter

Vision Services. Chapter Vision Services 39 Chapter 39 39.1 Enrollment..................................................................... 39-2 39.2 Benefits, Limitations, and Authorization Requirements...........................

More information

VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL

VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL AUGUST 2017 CSHCN PROVIDER PROCEDURES MANUAL AUGUST 2017 VISION SERVICES Table of Contents 40.1 Enrollment......................................................................

More information

VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL

VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL JUNE 2018 CSHCN PROVIDER PROCEDURES MANUAL JUNE 2018 VISION SERVICES Table of Contents 40.1 Enrollment......................................................................

More information

Clinical Policy: Refractive Surgery Reference Number: CP.MP. 391

Clinical Policy: Refractive Surgery Reference Number: CP.MP. 391 Clinical Policy: Refractive Surgery Reference Number: CP.MP. 391 Effective Date: November 2007 Last Review Date: January 2016 Coding Implications Revision Log See Important Reminder at the end of this

More information

Vision Services. Chapter

Vision Services. Chapter Vision Services 39 Chapter 39 39.1 Enrollment..................................................................... 39-2 39.2 Benefits, Limitations, and Authorization Requirements...........................

More information

VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL

VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL VISION SERVICES CSHCN SERVICES PROGRAM PROVIDER MANUAL JULY 2018 CSHCN PROVIDER PROCEDURES MANUAL JULY 2018 VISION SERVICES Table of Contents 40.1 Enrollment......................................................................

More information

Clinical Policy Title: Cardiac rehabilitation

Clinical Policy Title: Cardiac rehabilitation Clinical Policy Title: Cardiac rehabilitation Clinical Policy Number: 04.02.02 Effective Date: September 1, 2013 Initial Review Date: February 19, 2013 Most Recent Review Date: February 6, 2018 Next Review

More information

MEDICAL POLICY No R3 REFRACTIVE KERATOPLASTY / LASIK

MEDICAL POLICY No R3 REFRACTIVE KERATOPLASTY / LASIK REFRACTIVE KERATOPLASTY / LASIK Effective Date: November 10, 2017 Review Dates: 7/07, 6/08, 6/09, 6/10, 8/10, 8/11, 8/12, 8/13, 8/14, 8/15, 8/16, 8/17 Date Of Origin: July 2007 Status: Current Summary

More information

Ophthalmology Quick Reference Card

Ophthalmology Quick Reference Card Purpose: Provide guidance for documentation required to assign the most appropriate and detailed codes in the new coding system (ICD-10 CM/PCS). Laterality Status of disease Origin of disease Left Right

More information

THERAPEUTIC CONTACT LENSES

THERAPEUTIC CONTACT LENSES THERAPEUTIC CONTACT LENSES Prof. Univ. Dr. Adriana Stanila Victor Papilian Faculty of Medicine Emergency Academic Hospital Sibiu Ocular Surface Research Center ROMANIA INTRODUCTION therapeuein greac =

More information

Clinical Policy Title: Zoster (shingles) vaccine

Clinical Policy Title: Zoster (shingles) vaccine Clinical Policy Title: Zoster (shingles) vaccine Clinical Policy Number: 18.02.10 Effective Date: June 1, 2018 Initial Review Date: April 10, 2018 Most Recent Review Date: May 1, 2018 Next Review Date:

More information

MEDICAL POLICY SUBJECT: GAS PERMEABLE SCLERAL CONTACT LENS (E.G., BOSTON OCULAR SURFACE PROSTHESIS)

MEDICAL POLICY SUBJECT: GAS PERMEABLE SCLERAL CONTACT LENS (E.G., BOSTON OCULAR SURFACE PROSTHESIS) MEDICAL POLICY SUBJECT: GAS PERMEABLE SCLERAL CONTACT PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including

More information

Clinical Policy Title: Corneal transplants (keratoplasty)

Clinical Policy Title: Corneal transplants (keratoplasty) Clinical Policy Title: Corneal transplants (keratoplasty) Clinical Policy Number: 10.03.04 Effective Date: April 1, 2015 Initial Review Date: November 19, 2014 Most Recent Review Date: November 16, 2017

More information

ICD-10-CM Are You Prepared? Part III Lids to Lens

ICD-10-CM Are You Prepared? Part III Lids to Lens ICD-10-CM Are You Prepared? Part III Lids to Lens Rebecca H. Wartman OD March 2014 With contributions from Doug Morrow OD & Harvey Richman OD Overview This webinar will provide an introduction to ICD-10-CM

More information

NEW OPPORTUNITIES OF USING THERAPEUTICAL CONTACT LENSES IN OCULAR SURGERY

NEW OPPORTUNITIES OF USING THERAPEUTICAL CONTACT LENSES IN OCULAR SURGERY NEW OPPORTUNITIES OF USING THERAPEUTICAL CONTACT LENSES IN OCULAR SURGERY Authors: Prof univ. dr. Adriana Stănilă, Dr. Elena Mihai, Dr. Adrian Teodoru, Dr. IonuŃ Costache The Clinical Department of Op

More information

Clinical Policy Title: Strep testing

Clinical Policy Title: Strep testing Clinical Policy Title: Strep testing Clinical Policy Number: 07.01.09 Effective Date: December 1, 2017 Initial Review Date: October 19, 2017 Most Recent Review Date: November 16, 2017 Next Review Date:

More information

FEP Medical Policy Manual

FEP Medical Policy Manual FEP Medical Manual 9.03.05 Corneal Topography/Computer-Assisted Corneal Topography/ Photokeratoscopy Last Review: September 2016 Next Review: September 2017 Related Policies 9.03.28 Corneal Collagen Cross-linking

More information

MEDICAL POLICY SUBJECT: CORNEAL ULTRASOUND PACHYMETRY. POLICY NUMBER: CATEGORY: Technology Assessment

MEDICAL POLICY SUBJECT: CORNEAL ULTRASOUND PACHYMETRY. POLICY NUMBER: CATEGORY: Technology Assessment MEDICAL POLICY SUBJECT: CORNEAL ULTRASOUND,, PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including

More information

2019 COLLECTION TYPE: MIPS CLINICAL QUALITY MEASURES (CQMS) MEASURE TYPE: Outcome High Priority

2019 COLLECTION TYPE: MIPS CLINICAL QUALITY MEASURES (CQMS) MEASURE TYPE: Outcome High Priority Quality ID #191 (NQF 0565): Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery National Quality Strategy Domain: Effective Clinical Care Meaningful Measure Area: Management

More information

Clinical Policy Title: Fluorescence in situ hybridization for cervical cancer screening

Clinical Policy Title: Fluorescence in situ hybridization for cervical cancer screening Clinical Policy Title: Fluorescence in situ hybridization for cervical cancer screening Clinical Policy Number: 01.01.02 Effective Date: April 1, 2015 Initial Review Date: January 21, 2015 Most Recent

More information

Dr. Harvey Richman, OD, FAAO, FCOVD Diplomate American Board of Optometry Executive Committee AOA Third Party Center Founder Ask the AOA Coding

Dr. Harvey Richman, OD, FAAO, FCOVD Diplomate American Board of Optometry Executive Committee AOA Third Party Center Founder Ask the AOA Coding Dr. Harvey Richman, OD, FAAO, FCOVD Diplomate American Board of Optometry Executive Committee AOA Third Party Center Founder Ask the AOA Coding Experts 92000 Codes Special Ophthalmological Services Describe

More information

Gas Permeable Scleral Contact Lens. Description

Gas Permeable Scleral Contact Lens. Description Subject: Gas Permeable Scleral Contact Lens Page: 1 of 6 Last Review Status/Date: December 2013 Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 3 Gas Permeable

More information

Note: This is an outcome measure and can be calculated solely using registry data.

Note: This is an outcome measure and can be calculated solely using registry data. Measure #191 (NQF 0565): Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery -- National Quality Strategy Domain: Effective Clinical Care DESCRIPTION: Percentage of patients

More information

Measure #191: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

Measure #191: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery Measure #191: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery 2012 PHYSICIAN QUALITY REPORTING OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION: Percentage

More information

Subject Index. Atopic keratoconjunctivitis (AKC) management 16 overview 15

Subject Index. Atopic keratoconjunctivitis (AKC) management 16 overview 15 Subject Index Acanthamoeba keratitis, see Infective keratitis Acute allergic conjunctivitis AKC, see Atopic keratoconjunctivitis Allergy acute allergic conjunctivitis 15 atopic keratoconjunctivitis 15

More information

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Outcome

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Outcome Quality ID #191 (NQF 0565): Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES:

More information

CORNEAL CONDITIONS CORNEAL TRANSPLANTATION

CORNEAL CONDITIONS CORNEAL TRANSPLANTATION GENERAL INFORMATION CORNEAL CONDITIONS CORNEAL TRANSPLANTATION WHAT ARE CORNEAL CONDITIONS? The cornea is the clear outer layer of the eye. Shaped like a dome, it helps to protect the eye from foreign

More information

Gas Permeable Scleral Contact Lens Archived Medical Policy

Gas Permeable Scleral Contact Lens Archived Medical Policy Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided

More information

Clinical Policy Title: Genicular nerve block

Clinical Policy Title: Genicular nerve block Clinical Policy Title: Genicular nerve block Clinical Policy Number: 14.01.10 Effective Date: October 1, 2017 Initial Review Date: September 21, 2017 Most Recent Review Date: October 19, 2017 Next Review

More information

Fitting Keratoconus and Other Complicated Corneas

Fitting Keratoconus and Other Complicated Corneas Fitting Keratoconus and Other Complicated Corneas Christine W Sindt OD FAAO Professor, Clinical Ophthalmology Director, Contact Lens Service University of Iowa Disclosure Consultant: ALCON Vision Care

More information

Clinical Policy: Implantable Miniature Telescope for Age Related Macular Degeneration Reference Number: CP.MP.517

Clinical Policy: Implantable Miniature Telescope for Age Related Macular Degeneration Reference Number: CP.MP.517 Clinical Policy: Implantable Miniature Telescope for Age Related Macular Reference Number: CP.MP.517 Effective Date: 11/16 Last Review Date: 11/17 See Important Reminder at the end of this policy for important

More information

Clinical Policy Title: Abdominal aortic aneurysm screening

Clinical Policy Title: Abdominal aortic aneurysm screening Clinical Policy Title: Abdominal aortic aneurysm screening Clinical Policy Number: 08.01.10 Effective Date: August 1, 2017 Initial Review Date: June 22, 2017 Most Recent Review Date: July 20, 2017 Next

More information

VISION SERVICES (INCLUDING REFRACTIVE SURGERY)

VISION SERVICES (INCLUDING REFRACTIVE SURGERY) , UnitedHealthcare Oxford Administrative Policy VISION SERVICES (INCLUDING REFRACTIVE SURGERY) Policy Number: VISION 016.31 T0 Effective Date: September 1, 2018 Table of Contents Page INSTRUCTIONS FOR

More information

Clinical Policy Title: Abdominal aortic aneurysm screening

Clinical Policy Title: Abdominal aortic aneurysm screening Clinical Policy Title: Abdominal aortic aneurysm screening Clinical Policy Number: 08.01.10 Effective Date: August 1, 2017 Initial Review Date: June 22, 2017 Most Recent Review Date: June 5, 2018 Next

More information

NEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY EDUCATIONAL OBJECTIVES AND GOALS

NEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY EDUCATIONAL OBJECTIVES AND GOALS NEW YORK UNIVERSITY SCHOOL OF MEDICINE DEPARTMENT OF OPHTHALMOLOGY EDUCATIONAL OBJECTIVES AND GOALS Revision Date: 6/30/06 Distribution Date: 7/6/06 The Department of Ophthalmology at the NYU Medical Center

More information

PREAMBLE TO MSC PAYMENT SCHEDULE: OPTOMETRY SERVICES

PREAMBLE TO MSC PAYMENT SCHEDULE: OPTOMETRY SERVICES PREAMBLE TO MSC PAYMENT SCHEDULE: OPTOMETRY SERVICES A. GENERAL PROVISIONS 1. Eye Examination Benefits Optometric benefits are services defined in Section 23 of the Medical and Health Care Services Regulations,

More information

Cornea and Contact Lens Institute of Minnesota. Specialty Contact Lenses and Vision Management

Cornea and Contact Lens Institute of Minnesota. Specialty Contact Lenses and Vision Management Cornea and Contact Lens Institute of Minnesota Specialty Contact Lenses and Vision Management We focus on specialty contact lenses. is a leading national resource for specialized contact lenses and eye

More information

Clinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden

Clinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden Clinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden Clinical Policy Number: 05.01.03 Effective Date: January 1, 2016 Initial Review Date: July 15, 2015 Most Recent Review Date:

More information

Clinical Policy Title: Corneal implants

Clinical Policy Title: Corneal implants Clinical Policy Title: Corneal implants Clinical Policy Number: 10.03.06 Effective Date: April 1, 2017 Initial Review Date: August 17, 2016 Most Recent Review Date: September 21, 2017 Next Review Date:

More information

Therapeutical bandage contact lenses for corneal protection

Therapeutical bandage contact lenses for corneal protection Therapeutical bandage contact lenses for corneal protection M i c h a e l B a e r t s c h i M.S.Optom Optom., M.Med.Educ Educ.,., F.A.A.O. Contact for text manuscript demands michael.baertschi baertschi@bluewin.ch

More information

Implantation of a corneal graft keratoprosthesis for severe corneal opacity in wet blinking eyes

Implantation of a corneal graft keratoprosthesis for severe corneal opacity in wet blinking eyes NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Implantation of a corneal graft keratoprosthesis for severe corneal opacity in wet blinking eyes The cornea

More information

Clinical Policy Title: Abdominal aortic aneurysm screening

Clinical Policy Title: Abdominal aortic aneurysm screening Clinical Policy Title: Abdominal aortic aneurysm screening Clinical Policy Number: 08.01.10 Effective Date: August 1, 2017 Initial Review Date: June 22, 2017 Most Recent Review Date: June 5, 2018 Next

More information

CODING COMPANION. Sample page. Ophthalmology A comprehensive illustrated guide to coding and reimbursement. Power up your coding. optum360coding.

CODING COMPANION. Sample page. Ophthalmology A comprehensive illustrated guide to coding and reimbursement. Power up your coding. optum360coding. CODING COANION 2019 Ophthalmology A comprehensive illustrated guide to coding and reimbursement Power up your coding optum360coding.com Contents Getting Started with Coding Companion...i Resequencing of

More information

FEP Medical Policy Manual

FEP Medical Policy Manual FEP Medical Policy Manual Effective Date: April 15, 2018 Related Policies: 2.01.16 Recombinant and Autologous Platelet-Derived Growth Factors for Healing and Other Non Orthopedic Conditions 7.01.113 Bioengineered

More information

rhngf for neurotrophic keratitis first line

rhngf for neurotrophic keratitis first line September 2015 Horizon Scanning Research & Intelligence Centre rhngf for neurotrophic keratitis first line LAY SUMMARY This briefing is based on information available at the time of research and a limited

More information

JINNAH SINDH MEDICAL UNIVERSITY STUDY GUIDE- OPHTHALMOLOGY YEAR 4,

JINNAH SINDH MEDICAL UNIVERSITY STUDY GUIDE- OPHTHALMOLOGY YEAR 4, INTRODUCTION Pakistan, the 7th most populous country in the world, has an urban population of 38.8% and rural dwellers of 61.2%. The country has faced challenges with vision impairment and blindness as

More information

Clinical Policy Title: Corneal implants

Clinical Policy Title: Corneal implants Clinical Policy Title: Corneal implants Clinical Policy Number: CCP.1257 Effective Date: April 1, 2017 Initial Review Date: August 17, 2016 Most Recent Review Date: August 30, 2018 Next Review Date: September

More information

Clinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden

Clinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden Clinical Policy Title: Genetic testing for G1691A polymorphism factor V Leiden Clinical Policy Number: 05.01.03 Effective Date: January 1, 2016 Initial Review Date: July 15, 2015 Most Recent Review Date:

More information

PROSE Treatment Information for Patients and Doctors

PROSE Treatment Information for Patients and Doctors PROSE Treatment Information for Patients and Doctors prior to getting my PROSE devices, life was hard. Everything that I loved to do was slipping away...that all changed the day I got PROSE. PROSE patient

More information

Clinical Policy Title: Altered auditory feedback devices for speech dysfluency (stuttering)

Clinical Policy Title: Altered auditory feedback devices for speech dysfluency (stuttering) Clinical Policy Title: Altered auditory feedback devices for speech dysfluency (stuttering) Clinical Policy Number: 17.02.02 Effective Date: January 1, 2016 Initial Review Date: August 19, 2015 Most Recent

More information

Cornea & External Disease research at Moorfields

Cornea & External Disease research at Moorfields Recruiting Research Studies Cornea & External Disease research at Moorfields Moorfields Eye Hospital wants to improve access to clinical research studies for all patients within the NHS and provide the

More information

Clinical Policy Title: Ketamine for treatment-resistant depression

Clinical Policy Title: Ketamine for treatment-resistant depression Clinical Policy Title: Ketamine for treatment-resistant depression Clinical Policy Number: 00.02.13 Effective Date: January 1, 2016 Initial Review Date: August 19, 2015 Most Recent Review Date: January

More information

Clinical Policy Title: Vacuum assisted closure in surgical wounds

Clinical Policy Title: Vacuum assisted closure in surgical wounds Clinical Policy Title: Vacuum assisted closure in surgical wounds Clinical Policy Number: 17.03.00 Effective Date: September 1, 2015 Initial Review Date: June 16, 2013 Most Recent Review Date: August 17,

More information

Clinical Policy Title: Corneal transplants (keratoplasty)

Clinical Policy Title: Corneal transplants (keratoplasty) Clinical Policy Title: Corneal transplants (keratoplasty) Clinical Policy Number: 10.03.04 Effective Date: April 1, 2015 Initial Review Date: November 19, 2014 Most Recent Review Date: November 16, 2016

More information

ICD 10 CM OPHTHALMOLOGY 2017 Quick Reference Guide SYMPTOMS CATARACT/LENS. with status migrainosus... G43.801

ICD 10 CM OPHTHALMOLOGY 2017 Quick Reference Guide SYMPTOMS CATARACT/LENS. with status migrainosus... G43.801 ICD 10 CM OPHTHALMOLOGY 2017 Quick Reference Guide SYMPTOMS Blurred vision (368.8)... H53.8 Contusion of eyeball and orbital tissues (921.3) eye initial encounter... S05.11XA subsequent encounter... S05.11XD

More information

Chapter. CPT only copyright 2010 American Medical Association. All rights reserved. 36Vision Services

Chapter. CPT only copyright 2010 American Medical Association. All rights reserved. 36Vision Services 36Vision Services Chapter 36 36.1 Enrollment..................................................................... 36-2 36.2 Benefits, Limitations, and Authorization Requirements...........................

More information

Sample page. Ophthalmology A comprehensive illustrated guide to coding and reimbursement CODING COMPANION

Sample page. Ophthalmology A comprehensive illustrated guide to coding and reimbursement CODING COMPANION CODING COMPANION 2018 Ophthalmology A comprehensive illustrated guide to coding and reimbursement POWER UP YOUR CODING with Optum360, your trusted coding partner for 32 years. Visit optum360coding.com.

More information

FUCH S DYSTROPHY & CATARACT SURGERY TREATMENT ALGORITHM

FUCH S DYSTROPHY & CATARACT SURGERY TREATMENT ALGORITHM FUCH S DYSTROPHY & CATARACT SURGERY TREATMENT ALGORITHM ΙΟΑΝΝΙS Α. MALLIAS, MD, PHD Director of the Dept. of Ophthalmology, Mediterraneo Hospital, Glyfada, Athens, Greece Clinical Fellow in Cornea and

More information

Clinical Policy Title: Measurement of serum antibodies to infliximab and adalimumab

Clinical Policy Title: Measurement of serum antibodies to infliximab and adalimumab Clinical Policy Title: Measurement of serum antibodies to infliximab and adalimumab Clinical Policy Number: 01.01.03 Effective Date: January 1, 2016 Initial Review Date: September 16, 2015 Most Recent

More information

Clinical Policy Title: Ear tubes (tympanostomy)

Clinical Policy Title: Ear tubes (tympanostomy) Clinical Policy Title: Ear tubes (tympanostomy) Clinical Policy Number: 11.03.05 Effective Date: January 1, 2015 Initial Review Date: September 17, 2014 Most Recent Review Date: September 21, 2017 Next

More information

Scleral Lenses: How do you know what is best

Scleral Lenses: How do you know what is best Scleral Lenses: How do you know what is best Alan Kwok, OD, FAAO, FSLS Tar Vaz, OD, FAAO Please silence all mobile devices and remove items from chairs so others can sit. Unauthorized recording of this

More information

Clinical Policy Title: Platelet rich plasma

Clinical Policy Title: Platelet rich plasma Clinical Policy Title: Platelet rich plasma Clinical Policy Number: 05.02.10 Effective Date: February 1, 2017 Initial Review Date: November 16, 2016 Most Recent Review Date: November 16, 2016 Next Review

More information

For members under 21, eye examination and glasses are covered as medically necessary with no other limits. Adults: 1. For members age 21 and older, be

For members under 21, eye examination and glasses are covered as medically necessary with no other limits. Adults: 1. For members age 21 and older, be Billing and Reimbursement Policies Policy Name: Vision Billing Guidelines Definition: Vision services involve the diagnosis and treatment of eye diseases, disorder and injuries. Services include routine

More information

Eye and Ocular Adnexa, Auditory Systems

Eye and Ocular Adnexa, Auditory Systems Eye and Ocular Adnexa, Auditory Systems CPT copyright 2011 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned

More information

Photochemical corneal collagen cross-linkage using riboflavin and ultraviolet A for keratoconus and keratectasia

Photochemical corneal collagen cross-linkage using riboflavin and ultraviolet A for keratoconus and keratectasia Photochemical corneal collagen cross-linkage using riboflavin and ultraviolet A for keratoconus and keratectasia Issued: September 2013 guidance.nice.org.uk/ipg466 NICE has accredited the process used

More information

Clinical Policy Title: Breast cancer index genetic testing

Clinical Policy Title: Breast cancer index genetic testing Clinical Policy Title: Breast cancer index genetic testing Clinical Policy Number: 02.01.22 Effective Date: January 1, 2017 Initial Review Date: October 19, 2016 Most Recent Review Date: October 19, 2016

More information

Interventional procedures guidance Published: 25 September 2013 nice.org.uk/guidance/ipg466

Interventional procedures guidance Published: 25 September 2013 nice.org.uk/guidance/ipg466 Photochemical corneal collagen cross-linkage using riboflavin and ultraviolet A for keratoconus and keratectasia Interventional procedures guidance Published: 25 September 2013 nice.org.uk/guidance/ipg466

More information

Clinical Policy Title: Platelet rich plasma

Clinical Policy Title: Platelet rich plasma Clinical Policy Title: Platelet rich plasma Clinical Policy Number: 05.02.10 Effective Date: February 1, 2017 Initial Review Date: November 16, 2016 Most Recent Review Date: November 16, 2017 Next Review

More information

Quick Reference Guide

Quick Reference Guide ICD-1O-CM Quick Reference Guide SYMPTOMS Blurred vision (368.8)... H53.8 Contusion of eyeball and orbital tissues (921.3) eye initial encounter... S05.11XA eye subsequent encounter... S05.11XD sequela...

More information

Learning Objectives. Disclosures 2/2/ BMT Pharmacists Conference Bandage Contact Lens Therapy for Severe Ocular GVHD

Learning Objectives. Disclosures 2/2/ BMT Pharmacists Conference Bandage Contact Lens Therapy for Severe Ocular GVHD 2015 BMT Pharmacists Conference Bandage Contact Lens Therapy for Severe Ocular GVHD Tueng T. Shen, M.D., Ph.D. Professor of Ophthalmology Adjunct, Bioengineering and Global Health Feb. 13 th, 2015 Learning

More information

FEP Medical Policy Manual

FEP Medical Policy Manual FEP Medical Policy Manual Effective Date: July15, 2017 Related Policies: 2.01.16 Recombinant and Autologous Platelet-Derived Growth Factors for Healing and Other Non Orthopedic Conditions 7.01.113 Bioengineered

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: endothelial_keratoplasty 9/2009 6/2018 6/2019 6/2018 Description of Procedure or Service Endothelial keratoplasty

More information

Course # Cutting Edge Cornea

Course # Cutting Edge Cornea Course # 061 Cutting Edge Cornea 44 year old female with sudden onset right eye pain. Has happened 3 times previouslyevery time first thing in the morning Cutting Edge Cornea Terri Kim, M.D. Chairman,

More information

SCLERAL LENS ASSESSMENT AND FITTING

SCLERAL LENS ASSESSMENT AND FITTING SCLERAL LENS ASSESSMENT AND FITTING Dr. Anita Gulmiri OD, FAAO Assistant Professor of Clinical Optometry New England College of Optometry This presentation has been created for Orbis International trainees

More information

Informed Consent for Excimer Laser Surface Ablation Surgery (PRK, LASEK, epi-lasik, and others)

Informed Consent for Excimer Laser Surface Ablation Surgery (PRK, LASEK, epi-lasik, and others) Informed Consent for Excimer Laser Surface Ablation Surgery (PRK, LASEK, epi-lasik, and others) Patient name (printed): Patient date of birth: Please review this information so you can make an informed

More information

Clinical Policy Title: Bone growth stimulators for non-healing fractures

Clinical Policy Title: Bone growth stimulators for non-healing fractures Clinical Policy Title: Bone growth stimulators for non-healing fractures Clinical Policy Number: 14.02.03 Effective Date: January 1, 2015 Initial Review Date: July 16, 2014 Most Recent Review Date: March

More information

Ocular and Periocular Trauma. Tina Rutar, MD. Assistant Professor of Ophthalmology and Pediatrics. Director, Visual Center for the Child

Ocular and Periocular Trauma. Tina Rutar, MD. Assistant Professor of Ophthalmology and Pediatrics. Director, Visual Center for the Child Ocular and Periocular Trauma Tina Rutar, MD Assistant Professor of Ophthalmology and Pediatrics Director, Visual Center for the Child University of California, San Francisco Phone: 415-353-2560 Fax: 415-353-2468

More information

MEDICAL POLICY I. POLICY POLICY TITLE VISUAL FIELD TESTING POLICY NUMBER MP

MEDICAL POLICY I. POLICY POLICY TITLE VISUAL FIELD TESTING POLICY NUMBER MP Original Issue Date (Created): August 9, 2002 Most Recent Review Date (Revised): March 25, 2014 Effective Date: June 1, 2014 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT

More information

Clinical Policy Title: Room humidifiers

Clinical Policy Title: Room humidifiers Clinical Policy Title: Room humidifiers Clinical Policy Number: 17.02.05 Effective Date: February 1, 2017 Initial Review Date: November 16, 2016 Most Recent Review Date: November 16, 2016 Next Review Date:

More information

Strategies for Anterior Segment Disease Management Mile Brujic, OD, FAAO 1409 Kensington Blvd Bowling Green, OH

Strategies for Anterior Segment Disease Management Mile Brujic, OD, FAAO 1409 Kensington Blvd Bowling Green, OH Strategies for Anterior Segment Disease Management Mile Brujic, OD, FAAO 1409 Kensington Blvd Bowling Green, OH 43402 brujic@prodigy.net 419-261-9161 Summary As optometry s scope of practice continues

More information

Degenerations. Conditions with cloudy cornea at birth or in infancy

Degenerations. Conditions with cloudy cornea at birth or in infancy Dermoids The lesions are choristomas, which are congenital masses of tissue that have been dislocated from their normal position Limbal dermoids--overlapping the cornea and sclera, often inferotemporally

More information

Scrub In. What is the function of vitreous humor? What does the pupil do when exposed to bright light? a. Maintain eye shape and provide color vision

Scrub In. What is the function of vitreous humor? What does the pupil do when exposed to bright light? a. Maintain eye shape and provide color vision Scrub In What is the function of vitreous humor? a. Maintain eye shape and provide color vision b. Maintain eye shape and refract light rays c. Provide night vision and color vision d. Provide night vision

More information

Convert Medi-Cal interim codes to nation HCPCS Level II and CPT-4 Level I codes.

Convert Medi-Cal interim codes to nation HCPCS Level II and CPT-4 Level I codes. Date: 11/8/06 Medi-Cal Provider Notice: #0065 Subject: Vision Care HIPAA Updates Effective 7/1/06 Effective for dates of service on or after 7/1/06, the following changes will be for vision services, pursuant

More information

ICD -10 -CM Pediatric/Strabismus

ICD -10 -CM Pediatric/Strabismus ICD -10 -CM Pediatric/Strabismus Amblyopia Deprivation H53.011 H53.012 H53.013 H53.019 Refractive H53.021 H53.022 H53.023 H53.029 Strabismic H53.031 H53.032 H53.033 H53.039 Suspect H53.041 H53.042 H43.043

More information

Clinical Policy Title: Computerized gait analysis

Clinical Policy Title: Computerized gait analysis Clinical Policy Title: Computerized gait analysis Clinical Policy Number: 15.01.01 Effective Date: October 1, 2014 Initial Review Date: May 21, 2014 Most Recent Review Date: June 22, 2017 Next Review Date:

More information

Clinical Policy Title: Vision therapy for visual system disorders

Clinical Policy Title: Vision therapy for visual system disorders Clinical Policy Title: Vision therapy for visual system disorders Clinical Policy Number: 10.02.01 Effective Date: March 1, 2014 Initial Review Date: November 20, 2013 Most Recent Review Date: November

More information

Amniotic Membrane Transplantation In Ocular Surface Disorders

Amniotic Membrane Transplantation In Ocular Surface Disorders Orginal Article Amniotic Membrane Transplantation In Ocular Surface Disorders Khalid Iqbal Talpur, Faiz Muhammad Halepota, Muhammad Pak J Ophthalmol 2005, Vol. 22 No. 3.................................................................................................

More information

Test Bank for Medical Surgical Nursing An Integrated Approach 3rd Edition by White

Test Bank for Medical Surgical Nursing An Integrated Approach 3rd Edition by White Test Bank for Medical Surgical Nursing An Integrated Approach 3rd Edition by White Link full download : http://testbankair.com/download/test-bank-for-medical-surgical-nursing-anintegrated-approach-3rd-edition-by-white/

More information

Clinical Policy Title: Tactile breast imaging

Clinical Policy Title: Tactile breast imaging Clinical Policy Title: Tactile breast imaging Clinical Policy Number: 05.01.07 Effective Date: February 1, 2018 Initial Review Date: November 16, 2017 Most Recent Review Date: January 11, 2018 Next Review

More information

Clinical Policy Title: Pharmacogenomic tests for psychiatric medications

Clinical Policy Title: Pharmacogenomic tests for psychiatric medications Clinical Policy Title: Pharmacogenomic tests for psychiatric medications Clinical Policy Number: 02.02.01 Effective Date: October 1, 2015 Initial Review Date: April 15, 2015 Most Recent Review Date: May

More information

Blepharoptosis repair is covered as functional/reconstructive surgery to correct: Visual impairment due to droop or displacement of the upper lid.

Blepharoptosis repair is covered as functional/reconstructive surgery to correct: Visual impairment due to droop or displacement of the upper lid. Premier Health Insuring Corporation POLICY AND PROCEDURE MANUAL MP.074.PC - Blepharoplasty This policy applies to the following line(s) of business: Premier Health Insuring Corporation MA DSNP Premier

More information