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Destruction of a localized lesion of the choroid involves a medical procedure aimed at treating conditions such as choroidal neovascularization (CNV). This condition is characterized by the formation of new, abnormal blood vessels that originate from the choroid and penetrate through the Bruch membrane into the subretinal pigment epithelium or the subretinal space. CNV is recognized as a significant contributor to vision loss, making its effective treatment crucial. The procedure utilizes photocoagulation, specifically laser photocoagulation, which employs focused laser energy to ablate or destroy the abnormal choroidal tissue. The process begins with the identification of the lesion, typically facilitated by fluorescein angiography, a diagnostic imaging technique that helps visualize the blood vessels in the eye. Once the lesion is clearly delineated, the surgeon applies multiple laser burns to the targeted area. Each application of the laser is followed by an assessment of the burn site, allowing the surgeon to monitor the tissue's response and determine the extent of the lesion that remains to be treated, including its thickness and diameter. This procedure may be conducted over one or more sessions, depending on the specific treatment plan and the patient's needs, with sessions potentially occurring on different days within a defined treatment period.
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The procedure is indicated for the treatment of localized lesions of the choroid, particularly in cases of choroidal neovascularization (CNV). CNV is often associated with various ocular conditions that can lead to significant vision impairment. The following are specific indications for performing this procedure:
The procedure for the destruction of a localized lesion of the choroid using photocoagulation involves several key steps, which are detailed as follows:
Post-procedure care is essential to ensure optimal recovery and monitor for any complications. Patients may experience some discomfort or visual disturbances following the laser treatment, which typically resolves over time. Regular follow-up appointments are necessary to assess the effectiveness of the treatment and to monitor for any recurrence of CNV. The surgeon may recommend specific post-operative instructions, including the use of prescribed eye drops to reduce inflammation and prevent infection. Patients should also be advised to report any unusual symptoms, such as increased pain or changes in vision, to their healthcare provider promptly.
| Short Descr | TREATMENT OF CHOROID LESION | Medium Descr | DSTRJ LESION CHOROID PC 1/> SESS | Long Descr | Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions | 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) | 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) | P4D - Eye procedure - treatment of retinal lesions | MUE | 1 | CCS Clinical Classification | 17 - Destruction of lesion of retina and choroid |
| RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 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. | 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). | 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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 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.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SG | Ambulatory surgical center (asc) facility service | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services |
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| 2011-01-01 | Changed | Guideline information changed. |
| 2009-01-01 | Changed | Code description changed |
| 2001-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |
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