Reimbursement for Transluminal Canal Dilation

Transluminal canal dilation, also known as canaloplasty, is an ophthalmic surgical procedure to dilate most or all of Schlemm’s canal to restore normal aqueous outflow to the collector channels.  In cases where the surgeon successfully circumnavigates 360º of Schlemm’s canal with the microcatheter, it permits installation of a 10-0 polypropylene suture.  The two ends of the suture are tied off in a loop to tension the trabecular meshwork and stent open the canal.  Alternately, when a suture cannot be placed, the canal is dilated as much as possible.

This FAQ addresses the following:

  1. What is transluminal canal dilation?
  2. What are the indications for transluminal canal dilation?
  3. What are the contraindications for transluminal canal dilation?
  4. What CPT code(s) is used to describe transluminal canal dilation?
  5. Does the CPT coding change with an ab interno or ab externo surgical approach? 
  6. What is the physician reimbursement for 66174 and 66175?
  7. Is transluminal canal dilation bundled with other services?
  8. How is the facility reimbursed for these services?
  9. What is the significance of the J1 indicator for 66174 and 66175?

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