Coding for Intravitreal Injections – Ophthalmology Management

Ophthalmologists, generally retina specialists, currently utilize intravitreal injections to treat a number of retinal conditions. Many of the diseases are severe, with poor prognoses and limited treatment options. They include: wet AMD, clinically significant macular edema, central retinal vein occlusion, retinal detachment, endophthalmitis, fungal infections, vitreous hemorrhage, and cytomegalovirus retinitis. Here is some information about coding for these injections that may be helpful to you.

This article answers the following questions:

  • What considerations affect coding and reimbursement of intravitreal injections?
  • Will insurance cover an offlabel, investigational or experimental use of medication delivered by intravitreal injection?
  • Is this procedure reimbursed during the postoperative period of another surgery?
  • What if the intravitreal injection is given in an ASC?
  • How is the injected substance reimbursed?

This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below:

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