Hospital outpatient departments, ASCs eligible for separate reimbursement for Omidria – Ocular Surgery News

On May 30, 2014, the U.S. Food and Drug Administration approved Omidria. It is used during cataract and lens replacement surgery to maintain pupil size by preventing intraoperative miosis and to reduce postoperative pain. A 4 mL single-patient-use vial of Omidria is diluted in a standard 500 mL container of balanced salt irrigating solution for use during the procedure; it requires no change in the surgeon’s operating routine.

The FDA-approved package insert notes that Omidria (phenylephrine and ketorolac injection 1%/0.3%, Omeros) is, “For administration to patients undergoing cataract surgery or intraocular lens replacement.” No other indications are listed. The table below contains all of the applicable CPT codes that fit these indications. While the list of codes is long, practically speaking there are only three codes that are commonly encountered. These three, based on the most recently published Medicare utilization data (CY 2012), are 66982, 66984 and 66986.

This article was published in Ocular Surgery News, and written by Corcoran’s Senior Consultant, Paul Larson, COE. To view the entire article in Ocular Surgery News, click on the link below:

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