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The CPT® Code 67516 refers to the procedure of a suprachoroidal space injection of a pharmacologic agent, which is classified as a separate procedure. This technique is primarily utilized to address various diseases affecting the posterior segment of the eye, which includes critical structures such as the retina, macula, and optic nerve. Common conditions treated with this injection include age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. The suprachoroidal space itself 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 transition zone that consists of several fibrous lamellae of varying thickness, which are situated close to the sclera. During the procedure, a specialized handheld microinjector, which consists of a syringe and a very fine needle, is employed 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 subsequently disperses around the globe and throughout the choroid and retina, facilitating targeted treatment of the underlying conditions.
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The suprachoroidal space 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 suprachoroidal space injection involves several critical steps to ensure accurate delivery of the pharmacologic agent. These steps include:
Following the suprachoroidal space injection, patients may experience some temporary discomfort or mild irritation in the eye. It is essential to monitor for any signs of complications, such as increased intraocular pressure or infection. Patients are typically advised to avoid strenuous activities and to follow any specific post-procedure care instructions provided by their healthcare provider. Follow-up appointments may be scheduled to assess the effectiveness of the treatment and to monitor the patient's recovery and overall eye health.
| Short Descr | SPRCHOROIDAL SPC NJX RX AGT | Medium Descr | SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT | Long Descr | Suprachoroidal space injection of pharmacologic agent (separate procedure) | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| 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 | 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.) | 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). | 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. | 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.) | JZ | Zero drug amount discarded/not administered to any patient |
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| 2024-01-01 | Added | Code Added. |
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