Ophthalmology and Optometry Coding Alert

Question: How should we bill for an aqueous shunt implant? We performed a non-penetrating deep sclerectomy with insertion of glaucoma drainage device. How do we get reimbursed for the supply of the shunt?

Louisiana Subscriber

Answer: The procedure code for the implant is 66180 (aqueous shunt to extraocular reservoir [e.g., Molteno, Schocket, Denver-Krupin]). The sclerectomy is part of the procedure for the aqueous shunt implant. Dont code it separately. For the shunt itself, use HCPCS code L8612 (aqueous shunt). Remember that the physician can bill for the shunt only if the physician provided it at his or her cost. Always check your local carrier policies regarding the use of HCPCS codes. It sounds as if you performed this in an ambulatory surgical center (ASC) that is owned by the physician or physician group. If that is the case, the supply billing should be part of the ASC facility claim and not the physicians claim.