2009 CPT Codes of Interest to Ophthalmology 65091 - 68899 Eye Codes
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Summary Benchmarks for Preferred Practice Pattern® Guidelines
SUMMARY BENCHMARKS FOR PREFERRED PRACTICE PATTERN® GUIDELINES TABLE OF CONTENTS Summary Benchmarks for Preferred Practice Pattern Guidelines Introduction . 1 Glaucoma Primary Open-Angle Glaucoma (Initial Evaluation) . 3 Primary Open-Angle Glaucoma (Follow-up Evaluation) . 5 Primary Open-Angle Glaucoma Suspect (Initial and Follow-up Evaluation) . 6 Primary Angle-Closure Disease (Initial Evaluation and Therapy) . 8 Retina Age-Related Macular Degeneration (Initial and Follow-up Evaluation) . 10 Age-Related Macular Degeneration (Management Recommendations) . 11 Diabetic Retinopathy (Initial and Follow-up Evaluation) . 12 Diabetic Retinopathy (Management Recommendations) . 13 Idiopathic Epiretinal Membrane and Vitreomacular Traction (Initial Evaluation and Therapy) . 14 Idiopathic Macular Hole (Initial Evaluation and Therapy) . 15 Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration (Initial and Follow-up Evaluation) . 17 Retinal and Ophthalmic Artery Occlusions (Initial Evaluation and Therapy) . 18 Retinal Vein Occlusions (Initial Evaluation and Therapy) . 19 Cataract/Anterior Segment Cataract (Initial and Follow-up Evaluation) . 20 Cornea/External Disease Bacterial Keratitis (Initial Evaluation) . 22 Bacterial Keratitis (Management Recommendations) . 23 Blepharitis (Initial and Follow-up Evaluation) . 24 Conjunctivitis (Initial Evaluation) . 25 Conjunctivitis (Management Recommendations) . 26 Corneal Ectasia (Initial Evaluation and Follow-up) . 27 Corneal Edema and Opacification (Initial Evaluation) . 28 Corneal Edema -
Description of Alternative Approaches to Measure and Place a Value on Hospital Products in Seven Oecd Countries
OECD Health Working Papers No. 56 Description of Alternative Approaches to Measure Luca Lorenzoni, and Place a Value Mark Pearson on Hospital Products in Seven OECD Countries https://dx.doi.org/10.1787/5kgdt91bpq24-en Unclassified DELSA/HEA/WD/HWP(2011)2 Organisation de Coopération et de Développement Économiques Organisation for Economic Co-operation and Development 14-Apr-2011 ___________________________________________________________________________________________ _____________ English text only DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS HEALTH COMMITTEE Unclassified DELSA/HEA/WD/HWP(2011)2 Health Working Papers OECD HEALTH WORKING PAPERS NO. 56 DESCRIPTION OF ALTERNATIVE APPROACHES TO MEASURE AND PLACE A VALUE ON HOSPITAL PRODUCTS IN SEVEN OECD COUNTRIES Luca Lorenzoni and Mark Pearson JEL Classification: H51, I12, and I19 English text only JT03300281 Document complet disponible sur OLIS dans son format d'origine Complete document available on OLIS in its original format DELSA/HEA/WD/HWP(2011)2 DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS www.oecd.org/els OECD HEALTH WORKING PAPERS http://www.oecd.org/els/health/workingpapers This series is designed to make available to a wider readership health studies prepared for use within the OECD. Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language – English or French – with a summary in the other. Comment on the series is welcome, and should be sent to the Directorate for Employment, Labour and Social Affairs, 2, rue André-Pascal, 75775 PARIS CEDEX 16, France. The opinions expressed and arguments employed here are the responsibility of the author(s) and do not necessarily reflect those of the OECD. -
Ciliary Zonule Sclera (Suspensory Choroid Ligament)
ACTIVITIES Complete Diagrams PNS 18 and 19 Complete PNS 23 Worksheet 3 #1 only Complete PNS 24 Practice Quiz THE SPECIAL SENSES Introduction Vision RECEPTORS Structures designed to respond to stimuli Variable complexity GENERAL PROPERTIES OF RECEPTORS Transducers Receptor potential Generator potential GENERAL PROPERTIES OF RECEPTORS Stimulus causing receptor potentials Generator potential in afferent neuron Nerve impulse SENSATION AND PERCEPTION Stimulatory input Conscious level = perception Awareness = sensation GENERAL PROPERTIES OF RECEPTORS Information conveyed by receptors . Modality . Location . Intensity . Duration ADAPTATION Reduction in rate of impulse transmission when stimulus is prolonged CLASSIFICATION OF RECEPTORS Stimulus Modality . Chemoreceptors . Thermoreceptors . Nociceptors . Mechanoreceptors . Photoreceptors CLASSIFICATION OF RECEPTORS Origin of stimuli . Exteroceptors . Interoceptors . Proprioceptors SPECIAL SENSES Vision Hearing Olfaction Gustation VISION INTRODUCTION 70% of all sensory receptors are in the eye Nearly half of the cerebral cortex is involved in processing visual information Optic nerve is one of body’s largest nerve tracts VISION INTRODUCTION The eye is a photoreceptor organ Refraction Conversion (transduction) of light into AP’s Information is interpreted in cerebral cortex Eyebrow Eyelid Eyelashes Site where conjunctiva merges with cornea Palpebral fissure Lateral commissure Eyelid Medial commissure (a) Surface anatomy of the right eye Figure 15.1a Orbicularis oculi muscle -
Infantile Aphakia and Successful Fitting of Pediatric Contact Lenses; a Case Presentation Authors: Virji N, Patel A, Libassi D
Infantile aphakia and successful fitting of pediatric contact lenses; a case presentation Authors: Virji N, Patel A, Libassi D An eleven month old male presents with bilateral aphakia secondary to congenital cataracts. The patient is currently successfully wearing B&L Silsoft Pediatric contact lenses, with good prognosis for vision in both eyes. I. Case History -Patient demographics: African American male, DOB 8/18/2009 -Chief complaint: patient presents with bilateral aphakia secondary to bilateral congenital cataract extraction -Ocular, medical history: S/P CE with anterior vitrectomy OD 09/22/2009, followed by OS 09/29/09. (+) squinting, rubs eyes, light sensitivity -Medications: none -Other salient information: patient has been seen by SUNY Contact Lens clinic since 2 months old, 10/14/2009 II. Pertinent findings -Clinical: Keratometry readings 41.00/41.25 @ 005 OD, 38.50/41.00 @ 046 Axial length, immeasurable Horizontal corneal diameter 8mm OD/OS Fundus exam WNL OU -Others: surgical dates: successful CE OU, September 2009 III. Differential diagnosis -Primary/leading: Idiopathic -Others: Posterior lenticonus, persistent hyperplastic primary vitreous, anterior segment dysgenesis, and posterior pole tumors, trauma, intrauterine infection (rubella), maternal hypoglycemia, trisomy (eg, Down, Edward, and Patau syndromes), myotonic dystrophy, infectious diseases (eg, toxoplasmosis, rubella, cytomegalovirus, and herpes simplex [TORCH]), and prematurity. (5) IV. Diagnosis and discussion -Elaborate on the condition: Bilateral infantile cataracts are one of the major treatable causes of visual impairment in children. (2) Hubel and Weisel’s research on the critical period of visual development determined that if infantile cataracts are removed within the critical period and appropriate correction is worn, vision is greatly improved. -
National Correct Coding Initiative's (Ncci) General
NATIONAL CORRECT CODING INITIATIVE’S (NCCI) GENERAL CORRESPONDENCE LANGUAGE AND SECTION-SPECIFIC EXAMPLES (FOR NCCI PROCEDURE TO PROCEDURE (PTP) EDITS AND MEDICALLY UNLIKELY EDITS (MUE)) EFFECTIVE: April 1, 2017* *INCLUDES 2017 HCPCS/CPT CODES Current Procedural Terminology (CPT) codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association. Applicable FARS\DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for the data contained or not contained herein. TABLE OF CONTENTS Section Page Introduction 5 General Correspondence Language for NCCI PTP Edits and Medically Unlikely Edits (MUEs) Standard preparation/monitoring services for anesthesia 8 HCPCS/CPT procedure code definition 8 CPT Manual or CMS manual coding instruction 8 Mutually exclusive procedures 9 Sequential procedure 9 CPT “Separate procedure” definition 9 More extensive procedure 9 Gender-specific procedures 10 Standards of medical/surgical practice 10 Anesthesia service included in surgical procedure 10 Laboratory panel 10 Deleted/modified edits for NCCI 11 Misuse of column two code with column one code 11 Medically Unlikely Edits (MUE) (Units of Service) 11 Deleted/modified edits -
Intraocular Lenses and Spectacle Correction
MEDICAL POLICY POLICY TITLE INTRAOCULAR LENSES, SPECTACLE CORRECTION AND IRIS PROSTHESIS POLICY NUMBER MP-6.058 Original Issue Date (Created): 6/2/2020 Most Recent Review Date (Revised): 6/9/2020 Effective Date: 2/1/2021 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY I. POLICY Intraocular Lens Implant (IOL) Initial IOL Implant A standard monofocal intraocular lens (IOL) implant is medically necessary when the eye’s natural lens is absent including the following: Following cataract extraction Trauma to the eye which has damaged the lens Congenital cataract Congenital aphakia Lens subluxation/displacement A standard monofocal intraocular lens (IOL) implant is medically necessary for anisometropia of 3 diopters or greater, and uncorrectable vision with the use of glasses or contact lenses. Premium intraocular lens implants including but not limited to the following are not medically necessary for any indication, including aphakia, because each is intended to reduce the need for reading glasses. Presbyopia correcting IOL (e.g., Array® Model SA40, ReZoom™, AcrySof® ReStor®, TECNIS® Multifocal IOL, Tecnis Symfony and Tecnis SymfonyToric, TRULIGN, Toric IO, Crystalens Aspheric Optic™) Astigmatism correcting IOL (e.g., AcrySof IQ Toric IOL (Alcon) and Tecnis Toric Aspheric IOL) Phakic IOL (e.g., ARTISAN®, STAAR Visian ICL™) Replacement IOLs MEDICAL POLICY POLICY TITLE INTRAOCULAR LENSES, SPECTACLE CORRECTION AND IRIS PROSTHESIS POLICY NUMBER -
Retinal Pigment Epithelial Tear Resembling Retinal Tear
Correspondence 333 References 5University of Washington/Fred Hutchinson 1 Dean WH, Banda L, Kambewa ES, Sherwin JC. Increased Cancer Research Center, Seattle, WA, USA intraocular pressure on the first post-operative day 6Department of Ophthalmology and Visual following sutureless extracapsular cataract surgery in Sciences, The University of Texas Medical Branch, Africa. Eye 2012; 26: 332. Galveston, TX, USA 2 Kim JY, Jo MW, Brauner SC, Ferrufino-Ponce Z, Ali R, 7Ophthalmic Consultants of Boston, Harvard Cremers SL et al. Increased intraocular pressure on the first Medical School, Boston, MA, USA postoperative day following resident-performed cataract E-mail: [email protected] surgery. Eye (Lond) 2011; 25: 929–936. Eye (2012) 26, 332–333; doi:10.1038/eye.2011.274; JY Kim1,2,3, M-W Jo4, SC Brauner3, Z Ferrufino-Ponce5, published online 11 November 2011 R Ali6, SL Cremers3 and BA Henderson7 1Department of Ophthalmology, University of Sir, Ulsan College of Medicine, Asan Medical Center, Retinal pigment epithelial tear resembling retinal Seoul, Republic of Korea tear 2Research Institute for Biomacromolecules, University of Ulsan College of Medicine, Case report Asan Medical Center, Seoul, Republic of Korea A 74-year-old Caucasian female with history of advanced 3Massachusetts Eye and Ear Infirmary, Harvard age-related macular degeneration presented with Medical School, Boston, MA, USA decreased vision in the right eye. The patient was 4Department of Preventive Medicine, University of treated with two ranibizumab injections for choroidal Ulsan College of Medicine, Seoul, Republic of Korea neovascularization 5 months prior without Figure 1 (a) SD-OCT showing RPE defect with overlying intact retina. -
Eyelid Conjunctival Tumors
EYELID &CONJUNCTIVAL TUMORS PHOTOGRAPHIC ATLAS Dr. Olivier Galatoire Dr. Christine Levy-Gabriel Dr. Mathieu Zmuda EYELID & CONJUNCTIVAL TUMORS 4 EYELID & CONJUNCTIVAL TUMORS Dear readers, All rights of translation, adaptation, or reproduction by any means are reserved in all countries. The reproduction or representation, in whole or in part and by any means, of any of the pages published in the present book without the prior written consent of the publisher, is prohibited and illegal and would constitute an infringement. Only reproductions strictly reserved for the private use of the copier and not intended for collective use, and short analyses and quotations justified by the illustrative or scientific nature of the work in which they are incorporated, are authorized (Law of March 11, 1957 art. 40 and 41 and Criminal Code art. 425). EYELID & CONJUNCTIVAL TUMORS EYELID & CONJUNCTIVAL TUMORS 5 6 EYELID & CONJUNCTIVAL TUMORS Foreword Dr. Serge Morax I am honored to introduce this Photographic Atlas of palpebral and conjunctival tumors,which is the culmination of the close collaboration between Drs. Olivier Galatoire and Mathieu Zmuda of the A. de Rothschild Ophthalmological Foundation and Dr. Christine Levy-Gabriel of the Curie Institute. The subject is now of unquestionable importance and evidently of great interest to Ophthalmologists, whether they are orbital- palpebral specialists or not. Indeed, errors or delays in the diagnosis of tumor pathologies are relatively common and the consequences can be serious in the case of malignant tumors, especially carcinomas. Swift diagnosis and anatomopathological confirmation will lead to a treatment, discussed in multidisciplinary team meetings, ranging from surgery to radiotherapy. -
Solved/Unsolved
Supplementary Materials: Supplementary table 1. Demographic details for the 54 individual patients (solved/unsolved) and their clinical features including cataract type, details of ocular co-morbidities, systemic features and whether cataract was the presenting feature (non-isolated cataract patients only). Abbreviations: yes (Y), no (N), not applicable (N/A). Age at Famil Ag M/ Age at Cataract Cataract Cataract Systemic Consanguinit Patient ID Gene Confirmed genetic diagnosis Ethnicity diagnosi Ocular co-morbidities FH y ID e F surgery type RE type LE presenting sign features y s (days) Aniridia, nystagmus, 23 years Posterior Posterior 1-1 1 PAX6 Aniridia White British 25 F - glaucoma, foveal N N N Y 4 months subcapsular subcapsular hypoplasia Cleft palate, epilepsy, high Aphakia Aphakia Macular atrophy, myopia, 7 years 9 7 years 8 arched palate, 2-1 2 COL11A1 Stickler syndrome, type II Not Stated 34 F (post- (post- lens subluxation, vitreous N N N months months flattened surgical) surgical) anomaly maxilla, short stature (5'2ft) Anterior segment dysgenesis, pupillary abnormalities including 12 years Posterior Posterior ectopic pupils, ectropion 3-1 3 CPAMD8 Anterior segment dysgenesis 8 Other, Any other 27 F - N N Y N 5 months subcapsular subcapsular UVAE and irodensis, nystagmus, dysplastic optic discs, large corneal diameters Gyrate atrophy of choroid and 23 years 29 years 1 Posterior Posterior Retinal dystrophy, Bipolar 4-1 4 OAT White British 42 F N N N retina 7 months month subcapsular subcapsular exotropia disorder 1 year 6 1 year -
Feasibility and Outcome of Descemet Membrane Endothelial Keratoplasty in Complex Anterior Segment and Vitreous Disease
CLINICAL SCIENCE Feasibility and Outcome of Descemet Membrane Endothelial Keratoplasty in Complex Anterior Segment and Vitreous Disease Julia M. Weller, MD, Theofilos Tourtas, MD, and Friedrich E. Kruse, MD escemet membrane endothelial keratoplasty (DMEK), Purpose: Descemet membrane endothelial keratoplasty (DMEK) is Da technique for posterior lamellar keratoplasty, involves becoming the method of choice for treating Fuchs endothelial a graft consisting only of the thin Descemet membrane with dystrophy and pseudophakic bullous keratopathy. We investigated adherent corneal endothelial cells. Introduced in 2006 by whether DMEK can serve as a routine procedure in endothelial Melles et al,1 DMEK is becoming more popular as several decompensation even in complex preoperative situations. studies show its superiority to Descemet stripping automated Methods: Of a total of 1184 DMEK surgeries, 24 consecutive eyes endothelial keratoplasty (DSAEK), regarding visual function 2,3 with endothelial decompensation and complex preoperative situa- and the time of visual rehabilitation after DMEK. However, tions were retrospectively analyzed and divided into 5 groups: group because DMEK grafts are thinner than DSAEK grafts, it is fi 1: irido-corneo-endothelial syndrome (n = 3), group 2: aphakia, more dif cult to handle them and typically takes surgeons subluxated posterior chamber intraocular lens or anterior chamber longer to learn. intraocular lens (n = 6), group 3: DMEK after trabeculectomy (n = In difficult situations, most surgeons prefer DSAEK or 4), group 4: DMEK with simultaneous intravitreal injection (n = 6), penetrating keratoplasty to DMEK because of its possible and group 5: DMEK after vitrectomy (n = 5). Main outcome intraoperative complications. For example, if corneal edema 4 parameters were best-corrected visual acuity, central corneal thick- is advanced, Ham et al recommend performing DSAEK first ness, endothelial cell density, rebubbling rate, and graft failure rate. -
Glaucoma-Related Adverse Events in the Infant Aphakia Treatment Study 1-Year Results
CLINICAL SCIENCES ONLINE FIRST Glaucoma-Related Adverse Events in the Infant Aphakia Treatment Study 1-Year Results Allen D. Beck, MD; Sharon F. Freedman, MD; Michael J. Lynn, MS; Erick Bothun, MD; Daniel E. Neely, MD; Scott R. Lambert, MD; for the Infant Aphakia Treatment Study Group Objectives: To report the incidence of glaucoma and glau- sistent fetal vasculature and 1.6 times higher for each coma suspects in the IATS, and to evaluate risk factors for month of age younger at cataract surgery. the development of a glaucoma-related adverse event in patients in the IATS in the first year of follow-up. Conclusions: Modern surgical techniques do not elimi- nate the early development of glaucoma following con- Methods: A total of 114 infants between 1 and 6 months genital cataract surgery with or without an intraocular of age with a unilateral congenital cataract were as- lens implant. Younger patients with or without persis- signed to undergo cataract surgery either with or with- tent fetal vasculature seem more likely to develop a glau- out an intraocular lens implant. Standardized defini- coma-related adverse event in the first year of follow- tions of glaucoma and glaucoma suspect were created and up. Vigilance for the early development of glaucoma is used in the IATS. needed following congenital cataract surgery, especially when surgery is performed during early infancy or for a Results: Of these 114 patients, 10 (9%) developed glau- child with persistent fetal vasculature. Five-year fol- coma and 4 (4%) had glaucoma suspect, for a total of 14 low-up data for the IATS will likely reveal more glaucoma- patients (12%) with a glaucoma-related adverse event in related adverse events. -
Plastic Surgery for Pigmented Hairy Naevus of the Eyelids by Excision and Masquerade Skin Graft
Brit. J. Ophthal. (I969) 53, 343 Br J Ophthalmol: first published as 10.1136/bjo.53.5.343 on 1 May 1969. Downloaded from Plastic surgery for pigmented hairy naevus of the eyelids By excision and masquerade skin graft B. HIRSHOWITZ AND D. MAHLER Department of Plastic Surgery, Rambam Government Hospital, Haifa, Israel The simultaneous excision of a lesion affecting the skin of both upper and lower eyelids carries with it the problem of skin replacement. Both aesthetic and functional require- ments will have to be met in the reconstruction. Ectropion could complicate such a repair, and loss of eyelashes would add to the disfigurement. All these aspects had to be considered in a patient with a darkly pigmented hairy naevus involving both eyelids and the surrounding skin. Case report copyright. A 15-year-old boy had a deeply pigmented hairy naevus of the upper and lower eyelids on the left side. The naevus extended to both inner and outer canthi, the eyebrow, and the temporal and cheek regions (Fig. i). The ciliary borders of both eyelids were also involved. The operation was indicated because of severe psychological disturbances engendered by this disfigurement. http://bjo.bmj.com/ F_I. i Appearance before operation ......... ..... on September 26, 2021 by guest. Protected Operative technique The naevus was almost completely excised, apart from its extension into the eyebrow. Both upper and lower eyelashes were removed together with the naevus. Care was taken not to interfere with the lacrimal punctum. Immobilization of both eyelids was attained by a continuous wire suture running intratarsally. In effect, this adaptation of eyelid margins resulted in almost a complete tarsorrhaphy.