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The CPT® Code 0465T refers to the procedure of a suprachoroidal injection of a pharmacologic agent, which is a targeted therapeutic intervention used primarily for treating various diseases affecting the posterior segment of the eye. This includes conditions such as age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. The suprachoroidal space, where the injection occurs, is a narrow anatomical area located between the choroid and the sclera, extending from the limbus (the border between the cornea and the sclera) to the optic nerve. This space is characterized by a defined inner layer of the choroid known as Bruch’s membrane, along with an outer layer that transitions close to the sclera, consisting of several fibrous lamellae that vary in thickness. During the procedure, a specialized handheld microinjector, which includes a syringe and a very fine needle, is utilized to deliver the pharmacologic agent. The needle is carefully inserted through the sclera, allowing the fluid to be injected into the posterior segment of the eye, where it disperses around the globe and throughout the choroid and retina. It is important to note that while Code 0465T captures the injection procedure itself, the pharmacologic agent used in the injection must be reported separately, as it is not included in this code.
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The suprachoroidal injection of a pharmacologic agent is indicated for the treatment of various diseases affecting the posterior segment of the eye. These conditions include:
The procedure for a suprachoroidal injection of a pharmacologic agent involves several key steps, which are detailed as follows:
Post-procedure care following a suprachoroidal injection includes monitoring the patient for any signs of complications, such as increased intraocular pressure or infection. Patients may experience temporary discomfort or blurred vision, which typically resolves shortly after the procedure. It is essential for patients to follow any specific instructions provided by the physician regarding activity restrictions, use of eye drops, and follow-up appointments to assess the effectiveness of the treatment and monitor for any potential side effects.
| Short Descr | SUPCHRDL NJX RX W/O SUPPLY | Medium Descr | SUPCHRDL NJX OF RX AGT W/O SUPPLY OF MEDICATION | Long Descr | Suprachoroidal injection of a pharmacologic agent (does not include supply of medication) | 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 | Procedure or Service, Multiple Reduction Applies | Berenson-Eggers TOS (BETOS) | none | MUE | Not applicable/unspecified. |
| 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) | GA | Waiver of liability statement issued as required by payer policy, individual case | JW | Drug amount discarded/not administered to any patient | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | 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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| 2023-12-31 | Deleted | Code Deleted. See 67516. |
| 2018-01-01 | Added | First appearance in codebook. |
| 2017-01-01 | Added | New Code for 2017 |
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