CPT® Code 0356T | Case2Code

Code deleted, see 68841

Official Description

Insertion of drug-eluting implant (including punctal dilation and implant removal when performed) into lacrimal canaliculus, each

Common Language Description

The procedure described by CPT® Code 0356T involves the insertion of a drug-eluting implant into the lacrimal canaliculus, which is a small duct that drains tears from the eye. This procedure includes punctal dilation and the removal of the implant if necessary. The lacrimal canaliculus connects to the lacrimal puncta, located at the inner corners of each eye, where tears are collected before draining into the nasolacrimal system. The drug-eluting implant, often referred to as an intracanalicular plug, is made from an absorbable polyethylene glycol hydrogel that is impregnated with medication. Common medications used in these implants include dexamethasone, which is utilized to manage postoperative inflammation and pain, and travoprost, which is indicated for the treatment of glaucoma and ocular hypertension. The implant is designed to provide a sustained release of the medication directly to the ocular surface, allowing for effective treatment while minimizing systemic exposure. As the implant is absorbed by the body, it typically dissolves completely after the treatment period. Additionally, a visualization agent is incorporated into the implant to facilitate monitoring of its retention and to assist in its removal if required before the treatment course is completed. This code is specifically utilized for the insertion of each implant, as well as for the removal procedure when it is performed.

1. Indications

The procedure associated with CPT® Code 0356T is indicated for specific conditions related to ocular health. The following are the primary indications for performing this procedure:

Postoperative Inflammation and Pain The insertion of the drug-eluting implant containing dexamethasone is indicated to manage inflammation and pain following ocular surgeries.
Glaucoma The implant containing travoprost is indicated for the treatment of glaucoma, a condition characterized by increased intraocular pressure that can lead to optic nerve damage.
Ocular Hypertension The procedure is also indicated for patients with ocular hypertension, where the pressure inside the eye is elevated, potentially leading to glaucoma.

2. Procedure

The procedure for the insertion of the drug-eluting implant into the lacrimal canaliculus involves several key steps, which are detailed below:

Step 1: Preparation The patient is positioned comfortably, and the eye area is prepared for the procedure. This may include the application of topical anesthetic drops to minimize discomfort during the insertion of the implant.
Step 2: Punctal Dilation The lacrimal puncta, which are the openings of the lacrimal canaliculi, are dilated using a specialized instrument. This step is crucial to facilitate the insertion of the drug-eluting implant into the canaliculus.
Step 3: Implant Insertion Once the puncta are adequately dilated, the drug-eluting implant is carefully inserted into the lacrimal canaliculus. The implant is designed to fit snugly within the canaliculus, ensuring proper placement for effective drug delivery.
Step 4: Monitoring and Removal (if necessary) After insertion, the implant's retention is monitored, and if required, it can be removed before the completion of the treatment course. The visualization agent within the implant aids in this process, allowing for easy identification and retrieval.

3. Post-Procedure

Following the procedure, patients may be monitored for any immediate adverse reactions or complications. It is important to provide post-procedure care instructions, which may include avoiding rubbing the eyes and following up with the healthcare provider to assess the effectiveness of the implant. The expected recovery time is generally minimal, as the procedure is minimally invasive. Patients should be informed that the implant will dissolve over time, and they may need to return for follow-up evaluations to ensure that the desired therapeutic effects are achieved and to address any ongoing ocular health concerns.

Short Descr	INSRT DRUG DEVICE FOR IOP
Medium Descr	INSERT DRUG IMPLANT INTO LACRIMAL CANAL FOR IOP
Long Descr	Insertion of drug-eluting implant (including punctal dilation and implant removal when performed) into lacrimal canaliculus, each
Status Code	Carriers Price the Code
Global Days	YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Berenson-Eggers TOS (BETOS)	I4B - Imaging/procedure - other
MUE	Not applicable/unspecified.