Ophthalmology and Optometry Coding Alert
Use J7316 for Jetrea
Question: My ophthalmologist has started using Jetrea to treat VMA. How should we code for it?
Washington Subscriber
Answer: Jetrea (ocriplasmin) is a drug approved by the FDA in 2012 to treat an eye condition called symptomatic vitreomacular adhesion (VMA). Jetrea is an enzyme that helps break down the proteins in the eye responsible for VMA (ICD-9 code 379.27, Vitreomacular traction).
Effective Jan. 1, 2014, HCPCS code J7316 (Injection, ocriplasmin, 0.125 mg) has been established for the supply of Jetrea injections. This should be reported as four units for a single-use vial, according to the manufacturer.
For the administration itself, report CPT® code 67028 (Intravitreal injection of a pharmacologic agent [separate procedure]).
Prior to 2014, coders would have had to submit unlisted J-codes J3490 (Unclassified drugs) or J3590 (Unclassified biologics).
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Use J7316 for Jetrea
Question: My ophthalmologist has started using Jetrea to treat VMA. How should we code for it? [...]
