iDetectives can play a lifelong role in keratoconus care
Thanks to your critical role in intervention, iLink® corneal cross-linking* may slow or halt progressive keratoconus to preserve your patient’s vision.
But the story doesn’t end there. As an iDetective, you have an ongoing opportunity to manage your patient’s vision care and monitor the condition to keep keratoconus from calling the shots.
What’s next for you and your patients?
By promptly referring patients for a keratoconus or cross-linking consult, you can partner with an iLink® provider, clueing them in when you suspect keratoconus and collaborating on the best course of action in the patients’ follow-up care after the diagnosis is confirmed.
Now that you’ve given patients peace of mind by addressing their progressive keratoconus with iLink®, you can focus on delivering ongoing care to help them get the most out of their vision. Most optometrists agree that follow-up care after iLink® is similar to photorefractive keratometry. There is no global period for iLink® corneal cross-linking.
Follow-up care might include†:
-
Between Days 1-7
Post-iLink® care with an ophthalmologist for 1 or 2 visits:
- Applying topical antibiotics and steroids
- Using eye lubricants frequently
- Advising patients not to rub their eyes
- Removing the bandage contact lens once the epithelium has healed
- Prescribing pain medication as needed
Keratoconus is a bilateral disease
Following the initial iLink® procedure, treatment for the second eye affected by progressive keratoconus should be scheduled as soon as possible.
-
During Month 1
Ongoing optometrist support:
- View optical coherence tomography imaging
- A line of demarcation may be seen in the stroma
- Assess the patient’s vision
- The cornea may steepen then flatten over the next few months
- Patients may experience transient corneal haze
- Evaluate the patient for glasses and contact lens prescriptions
Common codes for care following iLink®:
- Office visits (9921X)
- Contact lens fitting for keratoconus
(92072) - Scleral lenses (V2531)‡
- View optical coherence tomography imaging
-
Months 3, 6, and 12
Ongoing optometrist support:
- Continue monitoring topography
- CPT Code 92025
- Assess the patient’s vision
Common ICD-10 codes for topography performed following iLink®:
- Keratoconus, unstable (H18.62X)
- Corneal ectasia (H18.711)
- Keratoconus, unspecified (H18.60X)
- Continue monitoring topography
-
Between Days 1-7
Post-iLink® care with an ophthalmologist for 1 or 2 visits:
- Applying topical antibiotics and steroids
- Using eye lubricants frequently
- Advising patients not to rub their eyes
- Removing the bandage contact lens once the epithelium has healed
- Prescribing pain medication as needed
Keratoconus is a bilateral disease
Following the initial iLink® procedure, treatment for the second eye affected by progressive keratoconus should be scheduled as soon as possible.
-
During Month 1
Ongoing optometrist support:
- View optical coherence tomography imaging
- A line of demarcation may be seen in the stroma
- Assess the patient’s vision
- The cornea may steepen then flatten over the next few months
- Patients may experience transient corneal haze
- Evaluate the patient for glasses and contact lens prescriptions
Common codes for care following iLink®:
- Office visits (9921X)
- Contact lens fitting for keratoconus
(92072) - Scleral lenses (V2531)‡
- View optical coherence tomography imaging
-
Months 3, 6, and 12
Ongoing optometrist support:
- Continue monitoring topography
- CPT Code 92025
- Assess the patient’s vision
Common ICD-10 codes for topography performed following iLink®:
- Keratoconus, unstable (H18.62X)
- Corneal ectasia (H18.711)
- Keratoconus, unspecified (H18.60X)
- Continue monitoring topography
Key Reminders
It’s important to help set patient expectations.
Remind your patients that iLink® is not a refractive procedure and they will still need glasses or contact lenses.
Most patients may return to specialty lenses after a period ranging from 1 week to 3 months. Inform patients that their vision may fluctuate slightly after treatment.
There is NO GLOBAL PERIOD for an iLink® procedure. Follow-up appointments can be billed to insurance as office visits using E/M codes 9921X.†‡
Learn more about your role in keratoconus detection and referral
A win for your patients and your practice
The benefits of early keratoconus detection, iLink® referral, and treatment do more than just slow or halt disease progression to help preserve vision.
Benefits to your Patients
Benefits to your Practice
Keratoconus detection is just the beginning
If you have a patient who you suspect has keratoconus, it’s time to #FollowTheClues.
*Using Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5’-phosphate ophthalmic solution), and the KXL® system, the iLink® corneal cross-linking procedure from Glaukos is the only FDA-approved therapeutic treatment for patients with progressive keratoconus and corneal ectasia following refractive surgery.§2
†The timing and frequency of office visits and specific follow-up care is at the discretion of healthcare professionals and may vary by patient.
‡There are multiple HCPCS codes for the prescribing of different types of medically necessary contact lenses.
§Photrexa® Viscous and Photrexa® are manufactured for Avedro. The KXL® system is manufactured by Avedro. Avedro is a wholly owned subsidiary of Glaukos Corporation.
REFERENCES
- Lindstrom R, Berdahl J, Donnenfeld E, et al. Corneal cross-linking versus conventional management for keratoconus: a lifetime economic model. J Med Econ. 2021;24(1):410-420.
- Photrexa. Prescribing information. Avedro; 2022.