Download Therapeutic contact lenses - Providers

Clinical Policy Title: Therapeutic contact lenses
Clinical policy number: 10.02.01
Effective Date:
Initial Review Date:
Most Recent Review Date:
Next Review Date:
June 1, 2014
December 18, 2013
January 21, 2015
January 2016
Policy contains:
 Hydrophilic Contact Lens For
Corneal Bandage.
 Boston scleral lens.
 Scleral shell lens.
 Amniotic membrane lens (ProKera).
RELATED POLICIES: None
ABOUT THIS POLICY: Keystone First has developed clinical policies to assist with making coverage determinations. Keystone First clinical policies
are based on guidelines from established industry sources, such as the Centers for Medicare & Medicaid Services (CMS), state regulatory agencies,
the American Medical Association (AMA), medical specialty professional societies, and peer-reviewed professional literature. These clinical policies
along with other sources, such as plan benefits and state and federal laws and regulatory requirements, including any state- or plan-specific
definition of “medically necessary,” and the specific facts of the particular situation are considered by Keystone First when making coverage
determinations. In the event of conflict between this clinical policy and plan benefits and/or state or federal laws and/or regulatory requirements,
the plan benefits and/or state and federal laws and/or regulatory requirements shall control. Keystone First clinical policies are for informational
purposes only and not intended as medical advice or to direct treatment. Physicians and other health care providers are solely responsible for the
treatment decisions for their patients. Keystone First clinical policies are reflective of evidence-based medicine at the time of review. As medical
science evolves, Keystone First will update its clinical policies as necessary. Keystone First clinical policies are not guarantees of payment.
Coverage Policy
Keystone First considers the use of therapeutic contact lenses to be clinically proven and, therefore,
medically necessary when the following criteria are met:
1. Type of covered lens:
a. Contact lenses or intra-ocular lenses placed after cataract surgery are considered
prostheses and are a covered benefit unless otherwise specified by the member’s Benefit
Plan;
b. Hydrophilic soft contact lenses or gas-permeable fluid ventilated scleral lenses are
medically necessary prostheses when used in the management of severe corneal disease;
c. Boston Scleral Lens are a medically necessary prosthesis when used as a moist corneal
bandage if lubricants or drops are not appropriate; OR
d. Scleral shell contact lenses are medically necessary for the treatment of severe
keratoconjunctivitis sicca and/or when the orbit requires greater support because of the
loss of corneal strength.
—AND—
2. Functional impairment being corrected:
1
a. Not able to achieve vision of 20/40 or better despite best correction with eyeglasses or
typical contact lenses;
b. Lenses will delay/prevent the need or corneal transplantation; OR
c. Will improve performance of activities of daily living
Limitations: All other uses of therapeutic contact lenses are not medically necessary.
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Contact lenses for vision correction are subject to benefit plans of the individual member.
The use of contact lenses for treatment of visual perceptual dysfunction, such as dyslexia, has not
had consistent results in clinical studies so cannot be considered a medically necessary treatment.
Amniotic membrane transplantation has insufficient evidence in the peer-reviewed medical
literature to support its use over standard care.
Alternative Covered Services:
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Physician office visits.
Standard covered ocular surgery.
Standard medical management of corneal disease.
Background
Corneal pathology may cause correctable vision distortion, pain, or threaten sight. Vision may be corrected
by the use of refractive eyeglasses or contact lenses. These lenses are primarily used for correction of
myopia, hypermetropia, astigmatism, and presbyopia. In such situations, the use of contact lenses is as a
cosmetic substitute for eyeglasses. Refracting contact lenses may be rigid/hard lens, soft (hydrophilic,
hydrogel and silicone hydrogel), or gas permeable rigid lens.
Therapeutic contact lenses are designed to manage other ocular pathology beyond simple refractive
disorders. The corneal disorders for which contact lenses become therapeutic include such conditions as:
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Aphakia;
Prostheses following cataract surgery;
Stevens-Johnson syndrome, Toxic Epidermolysis Necrosis (TEN), chemical burns or other corneal
stem cell deficiencies;
Congenital anomalies;
Neurotrophic corneas;
Keratoconjunctivitis with reduced tear production;
Corneal involvement of systemic autoimmune disorders;
Corneal exposure disorders;
Epidermal ocular disorders; and
Keratoconus associated with irregular astigmatism.
There are several types of therapeutic lenses available for the management of these disorders. The use of
the various the lens options have not been standardized through randomized controlled trials; but there is
a general standard now accepted for the use:
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1. Corneal liquid bandage lens—These may be rigid gas-permeable scleral contact lenses (RGP-ScCL)
or a therapeutic contact lens (TSCLs). These are used to treat acute or chronic corneal disease such
as persistent epithelial defects as listed above. These lenses protect the cornea from drying effects
of air and may reduce pain and photophobia. Because such lenses cover the entire cornea with a
smooth surface they may improve vision that results from acute astigmatism.
2. Boston scleral lens (BSL)—This lens was developed through the Boston Foundation for Sight. It is a
specially designed fluid-ventilated, gas-permeable contact lens. The design allows a bubble-free
reservoir of oxygenated aqueous fluid to cover the corneal surface at a neutral hydrostatic
pressure. This design makes it well suited for severe corneal disease.
3. Scleral shell contact lens—unlike other types of lens, the scleral shell contact covers the entire
exposed surface of the eye. For individuals with severe dry eye such as keratoconjunctivitis, the
scleral shell lens can hold artificial tears that have been dropped into the eye. These lenses protect
the eye against further drying. The supporting nature of the scleral shell also allows support and
protection when severe corneal disease has rendered the person blind. Use of the scleral shell may
prevent enucleation by providing support for the rest of the eye.
4. Amniotic membrane transplant—rather than provide a contact lens in cases of severe thermal or
chemical burns to the cornea, there are a few trials using amniotic members that may be
transplanted to the area of burn to reduce pain and to accelerate healing. Review of such studies
by Cochrane and Hayes have not found sufficient evidence to warrant use as there is insufficient
data from published peer-reviewed articles to support its use (Clare 2012, Hayes 2013).
Methods
Searches:
Keystone First searched PubMed and the databases of:
 UK National Health Services Centre for Reviews and Dissemination.
 Agency for Healthcare Research and Quality’s National Guideline Clearinghouse and other evidence-based
practice centers.
 The Centers for Medicare & Medicaid Services.
Searches were conducted on December 8, 2013-December 10, 2013 using the terms “therapeutic contact lenses” and
“amniotic membrane”. Included were:
 Systematic reviews, which pool results from multiple studies to achieve larger sample sizes and greater precision
of effect estimation than in smaller primary studies. Systematic reviews use predetermined transparent methods
to minimize bias, effectively treating the review as a scientific endeavor, and are thus rated highest in evidencegrading hierarchies.
 Guidelines based on systematic reviews.
 Economic analyses, such as cost-effectiveness, and benefit or utility studies (but not simple cost studies),
reporting both costs and outcomes — sometimes referred to as efficiency studies — which also rank near the top
of evidence hierarchies.
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Findings
Most studies on the various medical uses of contact lenses have been single-site with relatively small
numbers enrolled. There were no recent meta-analyses found of therapeutic contact lenses or of head to
head comparisons between the various products.
Professional guidelines from the American Academy of Ophthalmology note the absence of such studies
and make recommendations that the professional engages with the patient describing the advantages of
various strategies, allowing the patient to be an active participant in the clinical judgment. There is
consensus that patients with corneal pathology that threatens to weaken the architecture of the eye should
be treated with appropriate medical therapy and/or supporting contact lenses.
Summary of Clinical Evidence
Citation
Content, Methods, Recommendations
Watson 2012
Key Points
 This was a meta-analysis that found only 7 randomized and 1 quasi-randomized trial on
the management of recurrent corneal erosion.
 .These various studies came to different independent conclusions as to management of
recurrent corneal erosions using oral tetracycline, contact lenses, or hypertonic saline
ointment.
 The therapeutic contact lens arm had older rigid lenses.
 The therapeutic contact lens arm was less able to reduce pain or promote healing
compared to the oral tetracycline or hypertonic saline ointment.
Hayes 2013
Key Point
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This is a meta-analysis of the literature around Boston Equalens scleral contact lens.
There were only four uncontrolled studies, where the endpoints were not clear.
.The descriptions from the four studies were consistent with significant relief of pain,
reduced photophobia and improved visual acuity.
Clare 2012
Key Point
Cochrane review
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This is a review from Cochrane Eyes and Vision Group Trials that found one RCT with
100 participants with ocular burns provided either standard treatment or amniotic
membrane transplant.
The study was flawed in that the control group had worse acuity at the start than did the
amniotic membrane transplant group. But the latter had better vision at the end.
The conclusion is that there is inadequate evidence supporting the treatment of ocular
surface burns with amniotic membrane transplant.
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POLICY UPDATE January 2015
Findings
Searches were updated on January 4, 2015. No new systematic reviews, evidence-based guidelines or
economic studies were found. Since the last review date of this policy, one clinical trial (ClinicalTrials.gov
Identifier: NCT01699750) has completed with published results (Maissa 2014), but these results would not
impact this clinical policy. Therefore, no changes to the policy are warranted.
Other clinical policies
CMS
National Coverage
Determination (NCD)
for Hydrophilic Contact
Lens For CORNEAL
Bandage (80.1)
Policy
Benefit Category
Incident to a physician's professional Service
Outpatient Hospital Services Incident to a Physician's Service
Note: This may not be an exhaustive list of all applicable Medicare benefit categories for
this item or service.
Item/Service Description
Some hydrophilic contact lenses are used as moist corneal bandages for the treatment of
acute or chronic corneal pathology, such as bullous keratopathy, dry eyes, corneal ulcers
and erosion, keratitis, corneal edema, descemetocele, corneal ectasis, Mooren's ulcer,
anterior corneal dystrophy, neurotrophic keratoconjunctivitis, and for other therapeutic
reasons.
Indications and Limitations of Coverage
Payment may be made under §1861(s)(2) of the Act for a hydrophilic contact lens approved
by the Food and Drug Administration (FDA) and used as a supply incident to a physician's
service. Payment for the lens is included in the payment for the physician's service to which
the lens is incident. Contractors are authorized to accept an FDA letter of approval or other
FDA published material as evidence of FDA approval. (See §80.4 of the NCD Manual for
coverage of a hydrophilic contact lens as a prosthetic device.)
National Coverage
Determination (NCD)
for Hydrophilic
Contact Lenses
(80.4)
Benefit Category
Prosthetic Devices
Note: This may not be an exhaustive list of all applicable Medicare benefit categories for
this item or service.
Indications and Limitations of Coverage
Hydrophilic contact lenses are eyeglasses within the meaning of the exclusion in
§1862(a)(7) of the Act and are not covered when used in the treatment of nondiseased eyes
with spherical ametrophia, refractive astigmatism, and/or corneal astigmatism. Payment
may be made under the prosthetic device benefit, however, for hydrophilic contact lenses
when prescribed for an aphakic patient.
Contractors are authorized to accept an FDA letter of approval or other FDA published
material as evidence of FDA approval. (See §80.1 of the NCD Manual for coverage of a
hydrophilic lens as a corneal bandage.)
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CMS
National Coverage
Determination (NCD)
for Scleral Shell
(80.5)
Policy
Benefit Category
Prosthetic Devices
Item/Service Description
Scleral shell (or shield) is a catchall term for different types of hard scleral contact lenses.
Indications and Limitations of Coverage
A scleral shell fits over the entire exposed surface of the eye as opposed to a corneal
contact lens which covers only the central non-white area encompassing the pupil and iris.
Where an eye has been rendered sightless and shrunken by inflammatory disease, a scleral
shell may, among other things, obviate the need for surgical enucleation and prosthetic
implant and act to support the surrounding orbital tissue.
In such a case, the device serves essentially as an artificial eye. In this situation, payment
may be made for a scleral shell under §1861(s)(8) of the Act.
Scleral shells are occasionally used in combination with artificial tears in the treatment of
"dry eye" of diverse etiology. Tears ordinarily dry at a rapid rate, and are continually
replaced by the lacrimal gland. When the lacrimal gland fails, the half-life of artificial tears
may be greatly prolonged by the use of the scleral contact lens as a protective barrier
against the drying action of the atmosphere. Thus, the difficult and sometimes hazardous
process of frequent installation of artificial tears may be avoided. The lens acts in this
instance to substitute, in part, for the functioning of the diseased lacrimal gland and would
be covered as a prosthetic device in the rare case when it is used in the treatment of "dry
eye."
Glossary
Cornea — The thin transparent covering over the anterior portion of the eye. The cornea covers
the iris, pupil and anterior chamber of the eye.
Corneal ectasia — A non-inflammatory progressive steepening and thinning of the corneal. This
may include keratoconus, pellucid marginal degeneration, keratoglobus, postkeratorefractive
ectasia and wound ectasia.
Keratoconjunctivitis sicca — Is also termed dry eye syndrome of xerophthalmia. The condition is
caused by reduced tear production or excessive tear evaporation.
Lens — The biconvex structure in the eye through which light entering the eye is focused on the
retina for vision.
Limbus — The border of the cornea that is continuous with the sclera.
Visual perceptual dysfunctions — Is a visual distortion caused by sensitivities to particular
wavelengths of light.
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Source in public domain:
http://en.wikipedia.org/wiki/File:Cornea.png
Related policies: Keystone First Utilization Management program description.
References
Professional society guidelines/others:
American Academy of Ophthalmology Cornea/External Disease Panel. Preferred Practice Pattern
Guidelines. Corneal Edema and Opacification Summary Benchmarks, San Francisco, CA; American Academy
of Ophthalmology; 2013. Available at: http://one.aao.org/preferred-practice-pattern/corneal-edemaopacification-ppp--2013. Accessed January 4, 2015.
American Academy of Ophthalmology Cornea/External Disease Panel. Preferred Practice Pattern
Guidelines. Corneal Ectasia. San Francisco, CA; American Academy of Ophthalmology; 2013. Available at:
http://one.aao.org/preferred-practice-pattern/corneal-ectasia-ppp--2013. Accessed January 4, 2015.
American Academy of Ophthalmology. Preferred Practice Pattern Guidelines. Dry Eye Syndrome. San
Francisco, CAa; American Academy of Ophthalmology; 2013. Available at: http://one.aao.org/preferredpractice-pattern/dry-eye-syndrome-ppp--2013. Accessed January 4, 2015.
American Academy of Pediatrics, Section on Ophthalmology, Council on Children with Disabilities, American
Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus and
American Association of Certified with Disabilities, American Academy of Ophthalmology, American
Orthoptists. Learning Disabilities, Dyslexia, and Vision. Pediatrics 2009 Aug;124(2); 837-44. Available at:
http://pediatrics.aappublications.org/content/124/2/837.long. Accessed January 4, 2015.
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Peer-reviewed references:
Clare G, Suleman H, Bunce C, Dua H. Amniotic membrane transplantation for acute ocular burns. Cochrane
Database Syst Rev. 2012 Sep 12;9:CD009379
Foulks GN, Harvey T, Raj CV. Therapeutic contact lenses: the role of high-Dk lenses. Ophthalmol Clin North
Am. 2003 Sep;16(3):455-61.
Hayes Inc. Hayes Medical Technology Directory Report. Boston Equalens Scleral Contact Lens (Polymer
Technology Corp.) for Severe Ocular Surface Disease. Lansdale, Pa: Hayes Inc.; October, 2006.
Hayes Inc. Hayes Medical Technology Directory Report. ProKera (Bio-Tissue Inc.) for the treatment of
corneal ulcers, Lansdale, Pa: Hayes Inc.; January, 2013.
Jacobs DS, Rosenthal P. Boston scleral lens prosthetic device for treatment of severe dry eye in chronic
graft-versus-host disease. Cornea. 2007 Dec;26(10):1195-9.
Maissa C, Guillon M, Cockshott N, Garofalo RJ, Lemp JM, Boclair JW. Contact lens lipid spoliation of
hydrogel and silicone hydrogel lenses. Optometry and Vision Science: official publication of the American
Academy of Optometry. 2014;91(9):1071-1083.
Szczotka-Flynn L, Diaz M. Risk of corneal inflammatory events with silicone hydrogel and low dk hydrogel
extended contact lens wear: a meta-analysis. Optom. Vis Sci. 2007 Apr;84(4):247-56.
Watson SL, Lee MH, Barker NH. Interventions for recurrent corneal erosions. The Cochrane Database of
Systematic Reviews. 2012;9:CD001861.
Clinical Trials:
Searched clinicaltrials.gov on January 4, 2015 using terms for “hydrophilic contact Lens” OR “corneal
bandage” OR “boston scleral lens’” OR “scleral shell lens” or “amniotic membrane”. Nine relevant studies
found.
Hyper-CL™ Lens (Hyper Osmotic Contact Lens) In Subjects Suffering From Corneal Edema.
http://ClinicalTrials.gov/show/NCT0189025.
Surgical Result of Pterygium Extended Removal Followed by Fibrin Glue Assisted Amniotic Membrane
Transplantation. http://ClinicalTrials.gov/show/NCT02015000.
The Role of Amniotic Membrane Transplantation in Ocular Chemical Burns.
http://ClinicalTrials.gov/show/NCT00370812.
Recurrent Pterygium Surgery With Mitomycin C Application Using Limbal Conjunctival Versus Amniotic
Membrane. http://ClinicalTrials.gov/show/NCT01319721.
Transplantation of Tissue Cultured Human Amniotic Epithelial Cells Onto Damaged Ocular Surfaces.
http://ClinicalTrials.gov/show/NCT00344708.
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Limbal Epithelial Stem Cell Transplantation: a Phase II Multicenter Trial.
http://ClinicalTrials.gov/show/NCT02318485.
Transplantation of Cultivated Corneal Epithelial Sheet in Patients With Ocular Surface Disease.
http://ClinicalTrials.gov/show/NCT01123044.
Bandage Contact Lens and Oral Analgesics Versus Patching and Oral Analgesics for Pain Following Pterygium
Surgery. http://ClinicalTrials.gov/show/NCT01249235.
A Comparison Between Bandage Contact Lens, Punctal Plugs and Standard Measures in Preventing Corneal
Injuries. http://ClinicalTrials.gov/show/NCT01961193.
Comparative In-Vivo Wetting Characteristics of Silicone Hydrogel Materials With Selected Lens Care
Systems, ClinicalTrials.gov Identifier: NCT01699750 The purpose of this study is to evaluate the lipid uptake,
wetting characteristics, and visual performance of AIR OPTIX® AQUA and ACUVUE® OASYS® with
HYDRACLEAR® contact lenses when used in conjunction with two contact lens care systems, OPTI-FREE®
PUREMOIST® MPDS and BIOTRUE®. This study has completed. See Maissa (2014).
Centers for Medicare and Medicaid Services (CMS) National Coverage Determination
National Coverage Determination (NCD) for Hydrophilic Contact Lens for Corneal Bandage (80.1):
http://cms.hhs.gov/medicare-coverage-database/details/ncddetails.aspx?NCDId=136&ncdver=1&DocID=80.1&bc=gAAAAAgAAAAAAA%3d%3d&. Accessed January 4,
2015.
National Coverage Determination (NCD) for Scleral Shell (80.5): http://www.cms.gov/medicare-coveragedatabase/details/ncd-details.aspx?NCDId=235&ncdver=1&bc=AAAAQAAAAAAA&. Accessed January 4,
2015.
National Coverage Determination (NCD) for Refractive Keratoplasty (80.7): http://cms.hhs.gov/medicarecoverage-database/details/ncddetails.aspx?NCDId=72&ncdver=1&DocID=80.7&kq=true&kq=true&bc=gAAAAAgAAAAAAA%3d%3d&.
Accessed January 4, 2015.
Local Coverage Determinations
None at this time.
Commonly Submitted Codes:
Below are the most commonly submitted codes for the service(s)/item(s) subject to this policy. This is not
an exhaustive list of codes. Providers are expected to consult the appropriate coding manuals and bill in
accordance with those manuals.
CPT Code
92071
Description
Fitting of contact lens for treatment of ocular surface disease
Comment
Key Code
9
92072
Fitting of contact lens for management of keratoconus; initial fitting
92311
Prescription of optical and physical characteristics of and fitting of contact lens,
with medical supervision of adaptation, corneal lens, both eyes, except for
aphakia
…corneal lens for aphakia, 1 eye
92312
…corneal lens for aphakia, both eyes
92314
…corneoscleral lens
92310
Key Code
Key Code
Key Code
ICD-9 Code /Description
Comment
695.10: Erythema multiforme, unspecified
696.11: Erythema multiforme minor
695.12: Erythema multiforme major
695.13: Stevens-Johnson syndrome
695.14: Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome
695.15:Toxic epidermal necrolysis
695.19: Other erythema multiforme
TO REPORT CHEMICAL AND TRAUMATIC INJURIES, USE THE FOLLOWING
CODES
372.06: Acute chemical conjunctivitis
871.0: Ocular laceration without prolapse of intraocular tissue
871.1: Ocular laceration with prolapse or exposure of intraocular tissue
871.2: Rupture of eye with partial loss of intraocular tissue
871.3: Avulsion of eye
871.4: Unspecified laceration of eye
871.5: Penetration of eyeball with magnetic foreign body
871.6: Penetration of eyeball with (nonmagnetic) foreign body
871.7: Unspecified ocular penetration
871.9: Unspecified open wound of eyeball
918.0: Superficial injury of eyelids and periocular area
918.1: Superficial injury of cornea
918.9: Other and unspecified superficial injuries of eye
10
ICD-9 Code /Description
Comment
940.2: Alkaline chemical burn of cornea and conjunctival sac
940.3: Acid chemical burn of cornea and conjunctival sac
940.4: Other burn of cornea and conjunctival sac
TO REPORT POST-RADIOTHERAPY COMPLICATIONS, USE THE FOLLOWING
CODE
990: Effects of radiation, unspecified
TO REPORT RECURRENT EROSION AND CONGENITAL OR POST-SURGICAL
LID DEFECTS, USE THE FOLLOWING CODES
371.42: Recurrent erosion of cornea
374.05: Trichiasis of eyelid without entropion
374.89: Other disorders of eyelid
374.9: Unspecified disorder of eyelid
743.62: Congenital deformity of eyelid
743.63: Other specified congenital anomaly of eyelid
TO REPORT OCULAR CICATRICIAL PEMPHIGOID, USE THE FOLLOWING CODE
694.61: Benign mucous membrane pemphigoid with ocular involvement
TO REPORT EXPOSURE KERATITIS, USE THE FOLLOWING CODE
370.34: Exposure keratoconjunctivitis
TO REPORT LACRIMAL AND MEIBOMIAN DUCT OBLITERATION OR
DEFICIENCY, USE THE FOLLOWING CODES
375.13: Primary lacrimal atrophy
375.14: Secondary lacrimal atrophy
375.15: Unspecified tear film insufficiency
375.69: Other change of lacrimal passages
375.89: Other disorder of lacrimal system
743.65: Specified congenital anomaly of lacrimal passages
743.9: Unspecified congenital anomaly of eye
TO REPORT SUPERIOR LIMBAL KERATOCONJUNCTIVITIS, USE THE
FOLLOWING CODES
11
ICD-9 Code /Description
Comment
370.32: Limbar and corneal involvement in vernal conjunctivitis
370.49: Other unspecified keratoconjunctivitis
TO REPORT SJÖGREN SYNDROME, USE THE FOLLOWING CODE
710.2: Sicca syndrome
TO REPORT INFLAMMATORY CORNEAL DEGENERATION, USE THE
FOLLOWING CODES
370.21: Punctate keratitis
371.40: Unspecified corneal degeneration
371.41: Senile corneal changes
371.43: Band-shaped keratopathy
371.44: Other calcerous degenerations of cornea
371.45: Keratomalacia NOS
371.46: Nodular degeneration of cornea
371.48: Peripheral degenerations of cornea
371.49: Other corneal degenerations
371.53: Granular corneal dystrophy
371.54: Lattice corneal dystrophy
371.55: Macular corneal dystrophy
371.60: Unspecified keratoconus
371.71: Corneal ectasia
371.9: Unspecified corneal disorder
372.31: Rosacea conjunctivitis
372.33: Conjunctivitis in mucocutaneous disease
372.64: Scarring of conjunctiva
TO REPORT NEUROTROPHIC CORNEAL DISEASE, USE THE FOLLOWING CODE
370.35: Neurotrophic keratoconjunctivitis
TO REPORT KERATOCONUS, USE THE FOLLOWING CODES
371.60: Unspecified keratoconus
12
ICD-9 Code /Description
Comment
371.61: Keratoconus, stable condition
371.62: Keratoconus, acute hydrops
TO REPORT BULLOUS KERATOPATHY, USE THE FOLLOWING CODE
371.23: Bullous keratopathy
TO REPORT PERMANENT KERATOPROSTHESIS, USE THE FOLLOWING CODE
V42.5: Cornea replaced by transplant
TO REPORT FILAMENTARY KERATITIS, USE THE FOLLOWING CODE
370.23: Filamentary keratitis
ICD-10
Code
HCPCS
Level II
S0515
Description
Description
Scleral lens, liquid bandage device, per lens
Comment
Comment
Key Code
13