Reimbursement for DSEK/DSAEK
Descemet’s stripping endothelial keratoplasty (DSEK) or Descemet’s stripping automated endothelial keratoplasty (DSAEK) are interchangeable terms for a corneal transplantation that replaces just the posterior diseased cornea, leaving the corneal surface relatively untouched. The procedure involves a small corneal incision through which the surgeon strips away diseased or opacified corneal endothelial cells and grafts the posterior ¼ to ⅓ donor cornea thickness to the inner surface of the recipient cornea.
This FAQ addresses the following:
- What is DSEK/DSAEK?
- When is DSEK/DSAEK indicated?
- Does Medicare cover this procedure?
- What CPT code(s) are used to describe DSEK/DSAEK?
- What is the Medicare reimbursement for DSEK/DSAEK?
- Does DSEK/DSAEK have a global surgical period?
- If surgery is performed in a HOPD or ASC, will Medicare pay a facility fee?
- How is the supply of tissue reimbursed?
- If there is an immediate postoperative pressure spike, is the post-operative visit billable?
- How is a reoperation billed if it requires a return to the operating room?
- Can DSEK/DSAEK be combined with cataract surgery?
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