CPT® Code 0376T | Case2Code

Official Description

Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the trabecular meshwork; each additional device insertion (List separately in addition to code for primary procedure)

Common Language Description

The procedure described by CPT® Code 0376T involves the insertion of an anterior segment aqueous drainage device, specifically designed for the treatment of chronic or progressive open-angle glaucoma. This procedure is performed without the use of an extraocular reservoir and utilizes an internal approach to effectively manage intraocular pressure. During the procedure, a small, self-sealing incision is made in the cornea, which is then deepened to access the anterior chamber of the eye. A specialized magnification lens, such as a gonioscope, is employed to accurately place and position the drainage device, also referred to as a shunt, at the angle of the anterior chamber. The terminal end of the drainage device is strategically positioned within the trabecular meshwork, facilitating the drainage of aqueous humor to alleviate pressure within the eye. Notably, the small corneal incision does not require closure, as its size allows for self-sealing, promoting a swift recovery. It is important to note that the initial insertion of an aqueous drainage device is reported using CPT® Code 0191T, while CPT® Code 0376T is designated for each additional device inserted during the same surgical session.

1. Indications

The insertion of an anterior segment aqueous drainage device is indicated for patients suffering from chronic or progressive open-angle glaucoma. This condition is characterized by increased intraocular pressure, which can lead to optic nerve damage and potential vision loss if not managed effectively. The procedure aims to reduce intraocular pressure by facilitating the drainage of aqueous humor, thereby improving the overall health of the eye and preserving vision.

Chronic Open-Angle Glaucoma This condition is marked by a gradual increase in intraocular pressure due to impaired drainage of aqueous humor, necessitating intervention to prevent optic nerve damage.
Progressive Open-Angle Glaucoma Patients with this condition experience worsening symptoms and increasing intraocular pressure, requiring additional measures to manage their glaucoma effectively.

2. Procedure

The procedure for the insertion of an anterior segment aqueous drainage device involves several critical steps to ensure proper placement and functionality of the device.

Step 1: Preparation The patient is positioned comfortably, and the eye is prepared for surgery. Anesthesia is administered to minimize discomfort during the procedure.
Step 2: Incision A small, self-sealing incision is made in the cornea. This incision is carefully deepened to access the anterior chamber of the eye, allowing for the insertion of the drainage device.
Step 3: Device Placement A gonioscope or similar magnification lens is utilized to visualize the angle of the anterior chamber accurately. The drainage device is then positioned at this angle, ensuring that the terminal end is correctly placed within the trabecular meshwork.
Step 4: Finalization Once the device is securely positioned, the small corneal incision does not require closure, as it is designed to self-seal. This promotes a quicker recovery for the patient.

3. Post-Procedure

After the insertion of the anterior segment aqueous drainage device, patients are typically monitored for any immediate complications. Post-procedure care may include the use of prescribed eye drops to prevent infection and manage inflammation. Patients are advised to follow up with their ophthalmologist to assess the effectiveness of the device and monitor intraocular pressure. Recovery is generally swift due to the self-sealing nature of the incision, but patients should be informed about potential signs of complications, such as increased pain or vision changes, that would necessitate immediate medical attention.

Short Descr	INSERT ANT SEGMENT DRAIN INT
Medium Descr	ANT SEGMENT INSERT DRAIN W/O RESERVOIR EA ADDL
Long Descr	Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the trabecular meshwork; each additional device insertion (List separately in addition to code for primary procedure)
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	Items and Services Packaged into APC Rates
Berenson-Eggers TOS (BETOS)	P4E - Eye procedure - other
MUE	Not applicable/unspecified.