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A keratoprosthesis is a medical device designed to serve as a synthetic replacement for the cornea, which is the transparent front part of the eye. This procedure is typically indicated in cases where a human donor corneal transplant has failed or when the likelihood of success for a donor transplant is low. The keratoprosthesis itself is made from a clear plastic material that mimics the natural cornea's transparency and curvature. During the procedure, the synthetic graft is carefully sutured into human donor tissue, which is then attached to the patient's existing damaged cornea. This complex surgical intervention aims to restore vision in patients who have severe corneal damage or disease. After the keratoprosthesis is securely positioned and sutured in place, a soft contact lens is applied over the eye. This lens is crucial as it must be worn continuously, 24 hours a day, to protect the eye and support the healing process following the surgery.
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The keratoprosthesis procedure is indicated for specific conditions and situations where traditional corneal transplants may not be viable. The following are the primary indications for performing this procedure:
The keratoprosthesis procedure involves several critical steps to ensure proper placement and functionality of the synthetic corneal graft. The following outlines the procedural steps involved:
Following the keratoprosthesis procedure, patients are typically monitored for any immediate complications. Post-operative care includes the continuous use of the soft contact lens, which is crucial for protecting the eye and supporting healing. Patients may also be prescribed medications, such as antibiotics or anti-inflammatory drugs, to prevent infection and manage inflammation. Regular follow-up appointments are necessary to assess the integration of the keratoprosthesis and monitor the overall health of the eye. Patients should be advised on signs of complications, such as increased pain, redness, or vision changes, and instructed to seek immediate medical attention if these occur.
| Short Descr | KERATOPROSTHESIS | Medium Descr | KERATOPROSTHESIS | Long Descr | Keratoprosthesis | 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P4A - Eye procedure - corneal transplant | MUE | 1 | CCS Clinical Classification | 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea |
| RT | Right side (used to identify procedures performed on the right side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 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.) | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | 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) | SG | Ambulatory surgical center (asc) facility service |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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