CPT® Code 0444T

1. Indications

The procedure described by CPT® Code 0444T is indicated for patients requiring sustained medication delivery to the ocular surface. The specific indications for this procedure include:

• Chronic Eye Conditions Patients suffering from chronic conditions such as glaucoma or dry eye syndrome may benefit from the continuous release of medication provided by the ocular insert.
• Post-Surgical Care Individuals who have undergone ocular surgery may require ongoing medication to aid in recovery and prevent complications.
• Medication Adherence Issues Patients who have difficulty adhering to a prescribed medication regimen may find the ocular insert a more effective solution for consistent medication delivery.

2. Procedure

The procedure for the initial placement of a drug-eluting ocular insert involves several detailed steps to ensure proper fitting and insertion. The steps are as follows:

• Step 1: Measurement of Intercanthal Distance The healthcare provider begins by measuring the intercanthal distance, which is the distance between the inner corners of the eyes. This measurement is crucial for selecting the appropriate size of the ocular insert to ensure a proper fit.
• Step 2: Application of Anesthetic A topical ophthalmic anesthetic may be instilled in the eye to minimize discomfort during the procedure. This step is essential for patient comfort and cooperation during the insertion process.
• Step 3: Retraction of the Upper Eyelid The upper eyelid is manually retracted to provide access to the upper fornix, which is the space between the eyelid and the eyeball. This allows the healthcare provider to place the insert accurately.
• Step 4: Insertion of the Upper Half of the Insert The drug-eluting ocular insert is then placed in the upper fornix, ensuring that it is positioned correctly for optimal drug delivery.
• Step 5: Retraction of the Lower Eyelid The lower eyelid is retracted either manually or with the aid of a scleral depressor to facilitate the placement of the lower half of the insert.
• Step 6: Insertion of the Lower Half of the Insert The lower half of the insert is positioned in the lower fornix, ensuring that a portion of the insert remains visible in the medial canthus, which is the inner corner of the eye.
• Step 7: Patient Instruction After the insertion, the patient is instructed on the proper care of the ocular insert, including how to manage it if it becomes slightly displaced. This education is vital for ensuring the effectiveness of the treatment.

3. Post-Procedure

Post-procedure care following the placement of a drug-eluting ocular insert involves monitoring for any immediate complications and ensuring the patient understands how to care for the insert. Patients are typically advised to avoid rubbing their eyes and to report any discomfort, excessive tearing, or signs of infection. Follow-up appointments may be scheduled to assess the position of the insert and the effectiveness of the medication delivery. If the insert needs to be removed, the procedure for removal is similar to the insertion process, where the lower lid is retracted to expose the insert, and the exposed ring is gripped and pulled from the eye. Proper follow-up care is essential to ensure the ongoing effectiveness of the treatment and to address any potential issues that may arise.