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Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment)

CPT4 code

Name of the Procedure:

Destruction of Localized Lesion of Choroid (e.g., Choroidal Neovascularization); Photodynamic Therapy, Second Eye, at Single Session (List Separately in Addition to Code for Primary Eye Treatment)

Summary

Photodynamic therapy is a medical procedure used to treat abnormal growth of blood vessels in the eye, particularly in the choroid layer. This description pertains specifically to treating the second eye in the same session as the first.

Purpose

This procedure targets conditions such as choroidal neovascularization, where abnormal blood vessels form beneath the retina. The goal is to prevent further vision loss and to maintain or possibly improve visual function.

Indications

  • Age-related macular degeneration (AMD)
  • Pathologic myopia
  • Central serous chorioretinopathy
  • Other choroidal vascular disorders

Preparation

  • Patients may need to fast for a few hours before the procedure.
  • Avoid certain medications as instructed by the physician.
  • Baseline visual acuity tests and eye imaging studies will be conducted.
  • Informed consent is required.

Procedure Description

  1. A photosensitizing agent is intravenously administered.
  2. After a specific period to allow the drug to reach the eye, a low-energy laser is targeted on the affected area.
  3. The laser activates the drug, which produces a reaction to destroy the abnormal blood vessels without damaging surrounding tissues.

Duration

The procedure usually takes about 20-30 minutes per eye.

Setting

Typically performed in an outpatient clinic or a specialized eye care center.

Personnel

  • Ophthalmologist (specializing in retinal disorders)
  • Trained nursing staff
  • Technicians to handle imaging and laser equipment

Risks and Complications

  • Temporary blurry vision
  • Sensitivity to light
  • Inflammation or irritation of the eye
  • Rarely, vision loss if surrounding tissues are unintentionally damaged
  • Allergy to the photosensitizing agent

Benefits

  • Stabilizes or improves vision
  • Minimally invasive with short recovery time
  • Reduces the risk of significant vision loss from choroidal neovascularization

Recovery

  • Patients should avoid direct sunlight and bright indoor light for 48 hours post-procedure.
  • Normal activities can generally resume the next day.
  • Follow-up visits are required to monitor the eye's response to treatment.

Alternatives

  • Anti-VEGF injections
  • Thermal laser photocoagulation
  • Observation, if the condition is stable and vision is not significantly affected

Patient Experience

  • Mild discomfort from the injection of the photosensitizing agent.
  • Bright lights during the procedure may cause temporary visual discomfort.
  • Post-procedural eye protection with sunglasses and hats is necessary to prevent light sensitivity.

This markdown description provides a comprehensive overview for patients and healthcare professionals alike, ensuring clear understanding and preparation for the procedure.

Medical Policies and Guidelines for Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment)

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