ArcScan announced positive results of its study using existing reimbursement codes for glaucoma imaging with the Insight 100, ArcScan’s FDA 510(k)-cleared precision point-and-shoot ultrasound device for imaging and biometry of the eye. Indicated for refractive surgical planning and evaluation of anterior segment pathology, the Insight 100 images and measures anterior chamber depth, angle-to-angle width, individual corneal layers, sulcus-to-sulcus width, anterior and posterior capsular surfaces, angles, and more—with micron level precision and repeatability, all in a patient-friendly device.
The Insight 100 generates a comprehensive glaucoma report with 24 relevant data points an ophthalmologist needs to manage a glaucoma patient, whether diagnosed or just a suspect, including the degree of angle closure. The glaucoma report is generated automatically after an anterior segment scan has been completed, much in the same way an epithelium map and keratoconus report is auto-generated by the Insight 100 after a cornea scan is completed.
Zachary Vest, MD, a glaucoma specialist at Mile High Eye Institute in Englewood, CO, just completed a small study of 3 patients to determine if existing reimbursement codes could be used to bill for the scans using the Insight 100 for evaluation of glaucoma suspects. These patients were referred to Dr. Vest because each of their conditions can be a cause of increased intraocular pressure with potential to cause damage to the optic nerve. Dr. Vest successfully billed for all of the patients using the 76513 CPT code with the supporting indications.
The first patient was a 17-year-old male with an iris cyst. “The Insight 100 provided a quick and easy way to scan the cyst for size as well as ensure it was truly cystic and not solid,” Dr. Vest said. “ArcScan’s device provided a solid base to monitor the cyst over time, as it allows for multiple cuts in a narrow arc, so that measurements will be in the same anatomic area.”
The second patient, referred to Dr. Vest for a second opinion, presented after placement of an implantable contact lens (ICL) resulted in her iris bowing forward. “Images from the Insight 100 clearly showed that the source of the problem was that the ICL was of the incorrect size,” Dr. Vest said.
The third patient presented with asymmetric pigmentation of the angle on gonioscopy and a possible posterior chamber intraocular lens in the sulcus space. “She only dilated to about 4 mm, so clear visualization of the type of lens and location of the lens was not possible. The ArcScan Insight 100 images clearly showed a 1-piece IOL sitting on the capsular bag as the source of the pigmentary dispersion. Having that information allowed me to come up with options for the patient rather than considering a surgical exploration to discover the source of the problem,” Dr. Vest said.
Another application of the Insight 100 of interest to glaucoma specialists like Dr. Vest is for monitoring anatomic narrow-angle patients. “Those patients who are still phakic but don’t seem to be currently at risk for angle closure can be objectively measured with the Insight 100 rather than just by gonioscopy to see if the angle is actually changing and how quickly,” Dr. Vest said.