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The CPT® Code 65130 refers to the procedure of inserting an ocular implant that is performed as a secondary intervention following evisceration, specifically within a scleral shell. Evisceration is a surgical procedure that involves the removal of the contents of the eye while leaving the scleral shell intact. In this context, the scleral shell is the outer protective layer of the eye that remains after the internal structures have been removed. The procedure begins with the careful opening of the closed scleral shell, if it has been previously sutured. An implant, which is a prosthetic device designed to replace the volume and shape of the removed ocular contents, is then selected based on the appropriate size needed for the individual patient. Once the implant is positioned within the scleral shell, the surgeon meticulously closes the sclera over the anterior surface of the implant. This closure is performed in a layered manner, which is crucial to ensure that the sclera does not contract excessively and that the implant remains securely in place, thereby preventing any potential extrusion of the implant. This procedure is essential for restoring the appearance of the eye and providing support for any subsequent prosthetic eye fitting.
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The procedure associated with CPT® Code 65130 is indicated for patients who have undergone evisceration of the eye and require the placement of an ocular implant within the remaining scleral shell. The following conditions may warrant this procedure:
The procedure for CPT® Code 65130 involves several critical steps to ensure the successful insertion of the ocular implant. The following outlines the procedural steps:
Post-procedure care following the insertion of an ocular implant involves monitoring for any signs of complications, such as infection or implant extrusion. Patients may be advised to follow specific aftercare instructions, which could include the use of prescribed medications, such as antibiotics or anti-inflammatory agents, to promote healing and reduce the risk of infection. Regular follow-up appointments are essential to assess the healing process and the stability of the implant. Additionally, patients may need to wait for a certain period before being fitted for a prosthetic eye, allowing adequate time for the scleral shell to heal properly around the implant.
| Short Descr | INSERT OCULAR IMPLANT | Medium Descr | INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL | Long Descr | Insertion of ocular implant secondary; after evisceration, in scleral shell | 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) | 1 - Statutory payment restriction for assistants at surgery applies 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 | 21 - Other extraocular muscle and orbit therapeutic procedures |
| 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). | 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) | 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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| Pre-1990 | Added | Code added. |
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