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Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral

CPT4 code

Name of the Procedure:

Fluorescein Angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral

Summary

Fluorescein Angiography is a diagnostic test that uses a special dye (fluorescein) and a camera to look at blood flow in the retina and choroid — layers at the back of the eye. The test helps doctors diagnose retinal conditions.

Purpose

The procedure assesses blood circulation in the retina and choroid to identify abnormalities such as blockages, leaks, or other vascular issues. The goals are to detect, diagnose, and monitor conditions affecting these areas to guide treatment plans.

Indications

  • Symptoms such as blurred vision, blind spots, or vision loss.
  • Conditions like diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, and other retinal disorders.
  • Follow-up evaluations after treatments to monitor progress.

Preparation

  • Patients may need to fast for a few hours before the test.
  • Certain medications may need to be adjusted; patients should consult their doctor.
  • An initial eye exam is typically performed.

Procedure Description

  1. Preparation: Eye drops are administered to dilate the pupils.
  2. Dye Injection: Fluorescein dye is injected into a vein in the arm.
  3. Imaging: A special camera takes a series of rapid, high-resolution images of the retina and choroid as the dye travels through the blood vessels.
  4. Interpretation: A specialist reviews the images to detect abnormalities.

Duration

The entire procedure usually takes about 20-30 minutes.

Setting

It is performed in an ophthalmology clinic or an outpatient facility equipped with the necessary imaging technology.

Personnel

  • Ophthalmologist or Retina Specialist
  • Trained Ophthalmic Technician or Nurse

Risks and Complications

  • Common: Mild nausea, temporary discoloration of the skin and urine.
  • Rare: Allergic reactions to the dye, which can range from mild (rash) to severe (anaphylaxis).
  • Injection site complications such as bruising or infection.

Benefits

  • Accurate diagnosis of various retinal and choroidal conditions.
  • Helps in planning and monitoring the effectiveness of treatments.
  • Early detection of issues can lead to better management and preservation of vision.

Recovery

  • Patients might experience temporary blurred vision and sensitivity to light for a few hours.
  • Normal activities can usually be resumed shortly after the procedure.
  • Follow-up appointments may be necessary for further evaluation or treatment.

Alternatives

  • Optical Coherence Tomography (OCT): Non-invasive imaging for retinal conditions but doesn't provide detailed vascular information.
  • Indocyanine Green Angiography: Uses a different dye and is particularly good for choroidal vascular issues.
  • Pros and cons will depend on the specific condition and individual patient needs.

Patient Experience

  • During the procedure, patients might feel a brief sting from the injection and mild, temporary discomfort.
  • After the procedure, they may notice a yellowish tinge to their skin and urine, which resolves within 24-48 hours.
  • Visual disturbances are common and temporary; patients should avoid driving until vision clears.

Pain management and comfort measures are generally not necessary beyond reassurance and observation.

Medical Policies and Guidelines for Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral

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