To be billed only if patient proceeds to eye surgery/procedure as indicated below
i) Eligible indications for billing 22399 include:
a) Intraocular lens (IOL) implant surgery following cataract removal.
b) Any procedure where a peribulbar or retrobulbar injection is needed and risk of eyeball perforation by the injection needle is a potential danger such as:
i. any ocular surgery requiring local anesthetic with peri or retro-bulbar block, e.g.: Ptyregium surgery, corneal transplant, retinal surgery;
ii. Retrobulbar injection of therapeutic agents.
c) Axial or pathological myopia-serial assessments.
d) Diagnosis of conditions where axial myopia is a diagnostic criteria (e.g.: Marfan's).
e) Posterior staphyloma-serial assessments.
f) Pre-operative assessment for radioactive plaque implant - Brachytherapy for ocular melanoma.
Provide indication in note record when non-lOL implant indicated A-scan is performed.
Claims for IOL implant patients should indicate either:
- R/L for cataract surgery -on wait list or
- R/L eye for cataract surgery (with the surgery date indicated).
Limited to once per year, per eye. A note record indicating the need for additional scans is required.
Please reference the billing pre-amble for these relevant interpretations of this billing code:See Pre-Amble Notes