Prior Auth Required

65780 - Ocular surface reconstruction; amniotic membrane transplantation, multiple layers

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Procedure / ServiceOcular surface reconstruction; amniotic membrane transplantation, multiple layers
Procedure / Service Description

Code NAME/DESCRIPTION COMMENTS - 64644 Chemodenervation of one extremity; 5 or more muscles 65779 Placement of amniotic membrane on the ocular surface; single layer, sutured 65780 Ocular surface reconstruction; amniotic membrane transplantation, multiple layers 65781 Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor) 65820 Goniotomy

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  • Submit clinical notes if requested by the plan
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