Intravitreal Injections: A Coding and Reimbursement Review
Date: August 2, 2004
Ophthalmologists, particularly retinal specialists, have recently demonstrated significant enthusiasm for intravitreal injections to treat a variety of conditions. Medicare’s database of paid claims from 1998 to 2002 shows a 250.4 percent increase in the utilization of 67028 intravitreal injection of a pharmacological agent, separate procedure. At this time, injections of triamcinolone (Kenalog) account for most of the increase. The following list of considerations affect coding and reimbursement for intravitreal injections: indications, substance injected, concurrent surgical procedure, history of prior surgical procedure, whether the injection is within the postoperative period of another procedure, and location where the intravitreal injection is given.