Plus, the stent procedure takes much less time than a trabeculoplasty,
the more common and time-consuming treatment for this type of
glaucoma. The stents, which run $1,450, can be inserted as a stand-
alone procedure or in conjunction with a cataract surgery, and they're
reimbursed by CMS.
"This procedure is generally reimbursed well by CMS, but you'll
want to keep in mind it's billed through a temporary code," says Diane
Repko, RN, nurse director of the Eye Surgery Center of Western Ohio.
"That means you'll want to do your homework — always pre-autho-
rize and be prepared to jump through the hoops some payers make
you jump through to get paid using temporary codes."
Temporary codes (CPT Category III) represent emergent or experi-
mental services, technology and procedures, and are used for data
collection purposes to support widespread usage or to provide docu-
mentation for the FDA approval process.
Beside the implants, eye centers generally have everything they
need in place to conduct these procedures. But like much new OR
technology, you'll have to rely heavily on your sales rep to talk you
through the finer points of the implant. "Reps tend to focus solely on
the physician and ignore nurses and techs, which is frustrating," say
Ms. Repko. Whenever possible, ask your sales rep to speak to the
entire clinical staff outside of the OR to answer questions or concerns
about the new procedure, she adds. When it comes to scheduling, you
may want to wait for the end of the day to do these procedures — at
least initially.
"We do a lot of straight-up cataracts, and we don't want to bottle-
neck ourselves with delays early on, so we do all our Xen's (stents) at
the end of the day," says Ms. Repko. The instrumentation takes about
10 to 15 minutes to set up and the procedure itself takes 10 to 15 min-
utes, depending on the surgeon, adds Ms. Repko.
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