CPT® Code 0444T

Initial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral

The procedure described by CPT® Code 0444T involves the initial placement of a drug-eluting ocular insert beneath one or more eyelids. This insert is a specialized medical device designed to deliver medication directly to the eye over an extended period. The ocular insert is composed of a thin, sterile, multi-layered structure, featuring an inner polymeric support that provides stability and an outer layer that is impregnated with a specific drug or medication. When placed under the eyelid, the insert rests on the conjunctiva, which is the membrane covering the white part of the eye and the inner eyelids. The unique design of the insert allows lacrimal fluid, which is the natural fluid produced by the tear glands, to permeate the outer membrane of the device. This process facilitates the controlled diffusion of the medication into the ocular surface, ensuring a steady release of the drug over time. To perform the insertion, the healthcare provider first measures the intercanthal distance, which is the distance between the inner corners of the eyes, to select the appropriate size of the ocular insert. Prior to the procedure, a topical ophthalmic anesthetic may be applied to minimize discomfort for the patient. The upper eyelid is then manually retracted to allow access to the upper fornix, where the insert is placed. Following this, the lower eyelid is also retracted, either manually or with the assistance of a scleral depressor, to position the lower half of the insert in the lower fornix. It is important that a portion of the insert remains visible in the medial canthus, which is the inner corner of the eye. After the placement, the patient receives instructions on how to care for the insert and manage it if it becomes slightly displaced. For removal, the lower lid is retracted to expose the insert, and the exposed ring of the insert is gripped and pulled out of the eye. This comprehensive procedure encapsulates the initial fitting, training, and placement of the drug-eluting ocular insert, whether performed unilaterally or bilaterally.