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HUSKY Health Program Corneal Collagen CrossLinking Prior Authorization Request Form Phone: 1.800.440.5071 THIS FORM IS TO BE COMPLETED AND SIGNED BY THE ORDERING PROVIDER AND FAXED WITH CLINICAL DOCUMENTATION

How to fill out corneal collagen cross-linking prior

How to fill out corneal collagen cross-linking prior

1. Step 1: Prepare the patient for the procedure by administering anesthetic eye drops to numb the eye.
2. Step 2: Clean the area around the eye, including the eyelashes, with an antiseptic solution.
3. Step 3: Use a sterile drape to cover the patient's face, leaving only the eye exposed.
4. Step 4: Use a speculum to hold the eyelids open and ensure a clear view of the cornea.
5. Step 5: Apply riboflavin eye drops to the surface of the cornea every 2 minutes for 30 minutes.
6. Step 6: Use an ultraviolet light source to activate the riboflavin and promote cross-linking of the cornea.
7. Step 7: Monitor the patient for any signs of discomfort or adverse reactions during and after the procedure.
8. Step 8: Prescribe antibiotic and anti-inflammatory eye drops for the patient to use post-procedure.
9. Step 9: Provide the patient with instructions for post-operative care and follow-up visits.

Who needs corneal collagen cross-linking prior?

1. Patients with progressive keratoconus, a condition characterized by a thinning and bulging of the cornea, may benefit from corneal collagen cross-linking prior.
2. Patients with corneal ectasia, a similar condition to keratoconus, may also be candidates for this procedure.
3. Patients who have experienced corneal thinning or weakening as a result of previous eye surgeries or conditions may require corneal collagen cross-linking prior.
4. Ultimately, the decision of who needs corneal collagen cross-linking prior is made by an ophthalmologist or corneal specialist after thorough evaluation and consideration of the individual patient's condition.

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What is corneal collagen cross-linking prior?

Corneal collagen cross-linking prior is a procedure used to strengthen the cornea in cases of keratoconus or corneal ectasia.

Who is required to file corneal collagen cross-linking prior?

Patients with keratoconus or corneal ectasia who are undergoing corneal collagen cross-linking treatment are required to file prior authorization.

How to fill out corneal collagen cross-linking prior?

To fill out corneal collagen cross-linking prior authorization, patients or their healthcare providers must provide detailed information about the diagnosis, treatment plan, and medical necessity.

What is the purpose of corneal collagen cross-linking prior?

The purpose of corneal collagen cross-linking prior authorization is to ensure that the treatment is medically necessary and meets the criteria for coverage by insurance providers.

What information must be reported on corneal collagen cross-linking prior?

Information such as the patient's medical history, diagnostic test results, treatment plan, and any prior treatments must be reported on corneal collagen cross-linking prior authorization.