Question: Kansas Subscriber Answer: Because the ophthalmologist doesn't have to perform 67255 on every patient who gets a shunt, be sure the documentation includes information about the scleral thinning or other reason for the reinforcement procedure to support medical necessity for the additional procedure. Link the appropriate glaucoma diagnosis to 66180 for the shunt insertion, and link 379.04 (Scleromalacia perforans) to 67255 for the graft.