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Implantation of an intravitreal drug delivery system involves the surgical placement of a device designed to release medication directly into the posterior segment of the eye. This method allows for a sustained release of therapeutic agents, which can be crucial for managing various ocular conditions. The procedure is particularly beneficial for patients suffering from diseases such as cytomegalovirus (CMV) retinitis, age-related macular degeneration, uveitis, diabetic retinopathy, and retinal venous occlusions. The implants, which can be either biodegradable or non-biodegradable, are designed to provide long-term treatment without the need for frequent injections. Non-biodegradable options include Vitrasert, which contains ganciclovir, an antiviral medication, and Retisert, which contains fluocinolone acetate, a corticosteroid. The implantation process typically occurs under local anesthesia, either in an ophthalmologist's office or a same-day surgery center. The procedure involves making a small incision in the pars plana, removing a portion of the vitreous gel, and placing the implant securely in the eye. This innovative approach not only enhances patient comfort by reducing the frequency of treatments but also improves the overall management of chronic eye conditions.
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The implantation of an intravitreal drug delivery system is indicated for the treatment of various ocular conditions that require sustained medication delivery to the posterior segment of the eye. The specific indications include:
The procedure for the implantation of an intravitreal drug delivery system involves several critical steps to ensure proper placement and function of the implant. The steps are as follows:
Following the implantation of the intravitreal drug delivery system, patients may require specific post-procedure care to ensure optimal recovery and effectiveness of the implant. Patients are typically monitored for any immediate complications, such as infection or bleeding. It is common for patients to experience some discomfort or transient changes in vision following the procedure. Instructions regarding the use of prescribed eye drops, activity restrictions, and follow-up appointments will be provided to ensure proper healing and to assess the implant's performance. Regular follow-up visits are essential to monitor the patient's response to the treatment and to manage any potential side effects associated with the medication released by the implant.
| Short Descr | IMPLANT EYE DRUG SYSTEM | Medium Descr | IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS | Long Descr | Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P4E - Eye procedure - other | MUE | 1 | CCS Clinical Classification | 20 - Other intraocular therapeutic procedures |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 1998-01-01 | Added | First appearance in code book in 1998. |
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