E984

PDF page 770 / Y4

GLAUCOMA FILTERING PROCEDURES
# E132 Glaucoma filtering procedures ab externo (e.g.
          trabeculectomy, trabeculotomy, deep sclerectomy,
          viscocanalostomy) .............................................................                  6         550.00          6
# E114 Plate and tube glaucoma drainage procedure........................                                  6         840.00          6
# E115 Minimally invasive glaucoma surgery or minimally invasive
          bleb surgery, ab interno or ab externo (e.g. Hydrus stent,
          iStent, Trabectome, Kahook dual blade, canaloplasty, XEN
          Gel Stent, PreserFlo MicroShunt) ......................................                          6         350.00          6
# E110   - with cataract extraction, all types of, by any procedure,
            includes extraction of native lens and insertion of artificial
            intraocular lens (same eye), to E132, E114, E115..... add                                                271.50
# E984   - following previous glaucoma filtering procedure, to E132,
            E114, E115................................................................ add                           137.50
         Payment rules:
         E132 is not eligible for payment for primary lensectomy or bleb repair.

Master, record 1669. Record Layout PDF, page 1.

E98420250401999999990000137500000000000000000000000000000000000000000000000

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