How To Use CPT Code 0445T

CPT 0445T describes the subsequent placement of a drug-eluting ocular insert under one or more eyelids, including re-training, and removal of an existing insert, either on one eye or both eyes. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of CPT code 0445T.

1. What is CPT Code 0445T?

CPT 0445T is used to describe the subsequent placement of a drug-eluting ocular insert under one or more eyelids. This procedure involves removing an existing insert and replacing it with a new drug-releasing device, similar to a contact lens, that slowly releases medication to treat glaucoma. The insert is placed under the eyelid on the sclera, not over the cornea. It may be performed on one eye or both eyes.

2. Official Description

The official description of CPT code 0445T is: ‘Subsequent placement of a drug-eluting ocular insert under one or more eyelids, including re-training, and removal of existing insert, unilateral or bilateral.’ It is important to note that if the drug-eluting implant is inserted and removed into the lacrimal canaliculus, CPT code 68841 should be used instead.

3. Procedure

1. The provider begins by removing the existing drug-eluting ocular insert from under the eyelid(s).
2. Next, the provider places a new drug-releasing device, similar to a contact lens, under one or more eyelids of either one eye or both eyes.
3. The patient is then re-trained on how to insert the new ocular insert properly.
4. The procedure is complete after the provider ensures that the patient understands the insertion technique and is comfortable with the new insert.

4. Qualifying circumstances

CPT code 0445T is used for patients who require subsequent placement of a drug-eluting ocular insert. This procedure is typically performed on individuals with glaucoma, a condition characterized by increased intraocular pressure. The drug-eluting insert slowly releases medication, such as timolol, to treat the condition. It is important to note that for the initial insertion, including fitting and training of the patient, CPT code 0444T should be reported instead.

5. When to use CPT code 0445T

CPT code 0445T should be used when a patient requires the subsequent placement of a drug-eluting ocular insert under one or more eyelids. It is important to note that this code is not appropriate for the initial insertion, fitting, and training of the patient. If the patient requires the initial placement of the insert, CPT code 0444T should be used instead.

6. Documentation requirements

To support a claim for CPT code 0445T, the provider must document the following information:

• The need for subsequent placement of the drug-eluting ocular insert
• The removal of the existing insert
• The placement of the new insert under one or more eyelids
• The re-training provided to the patient on how to insert the new ocular insert
• The patient’s understanding and comfort with the new insert

7. Billing guidelines

When billing for CPT code 0445T, ensure that the procedure involves the subsequent placement of a drug-eluting ocular insert under one or more eyelids. It is important to note that this code should not be reported if CPT codes 0446T to 0448T have already been performed in the previous seven days. Additionally, consider the location of the testing when coding these procedures, as pulmonary function tests have both a professional and technical component.

8. Historical information

CPT code 0445T was added to the Current Procedural Terminology system on July 1, 2016. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider removes an existing drug-eluting ocular insert and subsequently places a new insert under one eyelid of a patient with glaucoma.
2. A patient requires the subsequent placement of a drug-eluting ocular insert under both eyelids, and the provider performs the procedure accordingly.
3. After removing an existing insert, the provider places a new drug-releasing device under one eyelid of a patient with glaucoma, ensuring proper re-training and patient comfort.
4. A provider performs the subsequent placement of a drug-eluting ocular insert under both eyelids of a patient with glaucoma, following the removal of the previous insert.
5. Under the provider’s care, a patient undergoes the subsequent placement of a drug-eluting ocular insert under one eyelid, including re-training and removal of the existing insert.
6. A patient with glaucoma requires the subsequent placement of a drug-eluting ocular insert under both eyelids, and the provider performs the procedure accordingly, ensuring patient understanding and comfort.
7. Following the removal of an existing insert, a provider places a new drug-releasing device under one eyelid of a patient with glaucoma, providing re-training and ensuring patient satisfaction.
8. A provider performs the subsequent placement of a drug-eluting ocular insert under both eyelids of a patient with glaucoma, following the removal of the previous insert, and ensures patient comfort and understanding.
9. Under the provider’s care, a patient undergoes the subsequent placement of a drug-eluting ocular insert under one eyelid, including re-training and removal of the existing insert, to effectively manage their glaucoma.
10. A patient with glaucoma requires the subsequent placement of a drug-eluting ocular insert under both eyelids, and the provider performs the procedure accordingly, ensuring patient satisfaction and understanding.