CPT® Code 0198T

Official Description

Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report

Common Language Description

The CPT® Code 0198T refers to a specialized procedure known as the measurement of ocular blood flow through repetitive intraocular pressure sampling, which includes the interpretation of the results and the generation of a report. This procedure utilizes a miniaturized sensor that is integrated into the tip of a tonometer, a device commonly used to measure intraocular pressure (IOP). The design of the tonometer tip is concave, allowing it to conform to the shape of the cornea when it is placed on the eye. As the tonometer tip is positioned on the cornea, the central cornea adapts to the curvature of the tip, enabling accurate pressure readings. The sensor embedded in the tonometer tip is capable of capturing up to 100 IOP readings every second, providing a detailed assessment of the intraocular pressure dynamics. The measurement of ocular blood flow is derived from the pulse wave generated by the device, which reflects the heart rate and the mean difference between diastolic and systolic IOP. This specific measurement is referred to as ocular pulse amplitude (OPA), which serves as a significant indicator of the quality of ocular blood flow. The procedure is particularly beneficial in the diagnosis of normal tension glaucoma, a condition where optic nerve damage occurs despite normal IOP levels. Overall, this advanced testing method offers valuable insights into ocular health and assists healthcare professionals in making informed clinical decisions.

1. Indications

The procedure associated with CPT® Code 0198T is indicated for the assessment of ocular blood flow, particularly in patients suspected of having normal tension glaucoma. The following conditions and symptoms may warrant the performance of this test:

Normal Tension Glaucoma - This condition is characterized by optic nerve damage occurring despite normal intraocular pressure levels, making it essential to evaluate ocular blood flow for diagnosis and management.
Assessment of Ocular Blood Flow - The procedure is useful in measuring the quality of blood flow to the eye, which can be critical in various ocular conditions.
Monitoring of Ocular Health - Patients with a history of ocular diseases may require this test to monitor changes in ocular blood flow over time.

2. Procedure

The procedure for CPT® Code 0198T involves several key steps to ensure accurate measurement of ocular blood flow through intraocular pressure sampling. The following outlines the procedural steps:

Preparation of the Patient - The patient is positioned comfortably, and the eye to be tested is prepared for the procedure. This may involve the application of topical anesthetic drops to minimize discomfort during the test.
Placement of the Tonometer Tip - The concave tonometer tip is carefully placed on the central cornea. The design of the tip allows the cornea to conform to its shape, ensuring accurate pressure readings.
Measurement of Intraocular Pressure - Once the tonometer tip is in place, the embedded pressure sensor begins to take intraocular pressure readings. The sensor can capture up to 100 readings per second, providing a comprehensive dataset for analysis.
Generation of Pulse Wave - As the sensor collects IOP data, it simultaneously generates a pulse wave that reflects the heart rate and the mean difference between diastolic and systolic IOP. This pulse wave is crucial for calculating ocular pulse amplitude (OPA).
Data Interpretation - After the measurements are completed, the data is interpreted to assess ocular blood flow. The results are compiled into a report that outlines the findings and any relevant observations.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 0198T, patients may be monitored briefly to ensure there are no immediate adverse effects from the test. Typically, there are no significant post-procedure care requirements, and patients can resume their normal activities shortly after the test. However, it is advisable for patients to follow any specific instructions provided by the healthcare professional regarding eye care or follow-up appointments. The results of the test will be discussed with the patient during a subsequent visit, where further management or treatment options may be considered based on the findings.

Short Descr	OCULAR BLOOD FLOW MEASURE
Medium Descr	MEAS OCULAR BLOOD FLOW REPEAT IO PRES SAMP W/I&R
Long Descr	Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	T2D - Other tests - other
MUE	2
CCS Clinical Classification	220 - Ophthalmologic and otologic diagnosis and treatment

Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.