Ohio Subscriber
Answer: Report 66180 (Aqueous shunt to extraocular reservoir [e.g., Molteno, Schocket, Denver-Krupin]) for the implant of a Baerveldt drainage device. The implant drains "some of the aqueous fluid from the anterior chamber into a reservoir beneath the conjunctiva, lowering the pressure in the eye," according to the August 2003 CPT Assistant.
An aqueous shunt is a rare, complex procedure to treat glaucoma, performed far less frequently than typical treatments such as trabeculectomy.
The shunt procedure may also require that the ophthalmologist perform a scleral patch graft (67255, Scleral reinforcement [separate procedure]; with graft) during the same surgical session. The reason for the reinforcement is usually a sclera that is thin or weakened, sometimes from a previous surgery. The ophthalmologist performs this when inserting the shunt. If the graft is done on the same day as the shunt, report 67255.
For the shunt itself, use HCPCS code L8612 (Aqueous shunt).