How To Use CPT Code 0474T

CPT 0474T describes the insertion of an anterior segment aqueous drainage device, with the creation of an intraocular reservoir, using an internal approach into the supraciliary space. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0474T?

CPT 0474T can be used to describe the procedure in which a healthcare provider inserts an aqueous drainage device into the anterior segment of the eye, between the cornea and the lens. This device creates a reservoir in the supraciliary space, just below the eyebrow, to drain excess aqueous fluid from the eye and lower intraocular pressure in patients with glaucoma.

2. Official Description

The official description of CPT code 0474T is: ‘Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space.’

3. Procedure

1. The healthcare provider prepares the patient for the procedure, typically using topical anesthesia.
2. Using gonioscopy or other imaging guidance, the provider makes a small incision through the cornea.
3. An aqueous drainage device is inserted into the anterior segment of the eye, creating a bypass between the anterior chamber and the supraciliary space.
4. This bypass allows excess aqueous fluid to drain from the anterior chamber, helping to lower intraocular pressure.
5. The provider ensures hemostasis during the procedure to stop any bleeding.
6. A temporary patch is placed over the eye to protect it after the procedure.

4. Qualifying circumstances

CPT 0474T is used for patients with glaucoma who require the insertion of an anterior segment aqueous drainage device. The procedure is performed by a healthcare provider using an internal approach. The patient must have increased intraocular pressure due to glaucoma, and the device is inserted to help lower this pressure. The procedure involves creating a reservoir in the supraciliary space, which allows excess aqueous fluid to drain from the eye.

5. When to use CPT code 0474T

CPT code 0474T should be used when a healthcare provider performs the insertion of an anterior segment aqueous drainage device with the creation of an intraocular reservoir using an internal approach into the supraciliary space. This code is specific to this procedure and should not be used for other eye-related interventions or treatments.

6. Documentation requirements

To support a claim for CPT code 0474T, the healthcare provider must document the following information:

• Patient’s diagnosis of glaucoma and the need for the procedure
• Details of the procedure, including the specific device used and the approach taken
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional interventions performed during the procedure
• Post-procedure instructions given to the patient
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 0474T, ensure that the procedure is performed using an internal approach and that an anterior segment aqueous drainage device is inserted into the supraciliary space. It is important to follow the specific guidelines for reporting this code and to accurately document the details of the procedure. CPT code 0474T should not be reported with other codes unless there are additional interventions or treatments performed during the same session.

8. Historical information

CPT code 0474T was added to the Current Procedural Terminology system on July 1, 2017. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider inserts an anterior segment aqueous drainage device into the supraciliary space to create an intraocular reservoir for a patient with glaucoma.
2. Using an internal approach, a healthcare provider performs the procedure to lower intraocular pressure in a patient with advanced glaucoma.
3. An aqueous drainage device is inserted into the anterior segment of the eye, creating a bypass between the anterior chamber and the supraciliary space, for a patient with uncontrolled glaucoma.
4. A healthcare provider performs the procedure to manage intraocular pressure in a patient with primary open-angle glaucoma.
5. Using an internal approach, a healthcare provider inserts an anterior segment aqueous drainage device into the supraciliary space to alleviate intraocular pressure in a patient with secondary glaucoma.
6. The procedure is performed to create an intraocular reservoir and drain excess aqueous fluid from the eye in a patient with refractory glaucoma.
7. A healthcare provider inserts an anterior segment aqueous drainage device into the supraciliary space to help manage intraocular pressure in a patient with neovascular glaucoma.
8. Using an internal approach, a healthcare provider performs the procedure to lower intraocular pressure in a patient with angle-closure glaucoma.
9. An aqueous drainage device is inserted into the anterior segment of the eye, creating a reservoir in the supraciliary space, for a patient with juvenile glaucoma.
10. A healthcare provider performs the procedure to alleviate intraocular pressure in a patient with normal-tension glaucoma.