Technology Focus

Identify Posterior Changes

Acquire images and a quantitative analysis of retinal vasculature

In this Focus column, the author answers questions about a software package upgrade, based on firsthand experience with it.

Can you please describe the AngioWellness scan?

AngioWellness, from Optovue, is a report within the AngioVue Comprehensive software package. It combines OCT retinal thickness and ganglion cell thickness maps with an OCTA scan that shows macular vessel density and foveal avascular zone (FAZ) measurements. This information enables quantitative analysis of retinal structures and vasculature. AngioWellness is a free upgrade for AngioVue Comprehensive owners.

For whom is it indicated and contraindicated?

I offer the scan to all adult patients. Our practice has a 40% to 45% capture rate on comprehensive eye exams.

I also strongly recommend my diabetic patients and glaucoma suspects have this advanced testing. Reason being: The report gives optometrists information on early changes within the eye.

What results can an O.D. expect?

Several outcomes are possible: Normal results, which give the patient peace of mind, or early indicators of ocular disease, which help guide the management plan.

What benefits does the service provide to your practice?

My practice benefits in several ways: First, my patients appreciate that my practice invests in diagnostic testing that helps us find disease earlier. Also, the medical community has come to recognize my practice as a state-of-the-art eye care provider. Additionally, having a picture of what a patient’s retinal vasculature looks like helps to better educate the patient on his condition and the importance of following my recommendations. And, finally, I’ve been able to identify and help patients who need medical eye care, while reaping the financial rewards of doing so.

Regarding coding, AngioWellness, by Optovue, is a wellness or screening program and, therefore, is always an out-of-pocket expense. This might seem concerning to some. However, our practice is receiving little to no push back when the patient has to pay for the testing. If you detect something in the results, schedule the patient for a follow-up appointment, at which the AngioVue’s additional imaging scan packages can be utilized. Bill the patient’s medical insurance for anterior segment (92132), optic nerve (92133), or retina (92134) OCT, as indicated. [Note that OCTA (optic nerve or retina) does not have a separate CPT-code from OCT, so you can’t bill insurance for both OCTA and OCT].

Retinal and vascular images, via AngioWellness.
Image courtesy of Dr. Greg Caldwell

How do you discuss the scan with the patient?

My staff presents our advanced testing options when the patient checks in at the front desk. The staff member will let the patient know that I recommend these tests as an important step in protecting his vision. If the patient declines or has additional questions, I will discuss it during the exam and show a few examples of AngioWellness.

Is there anything you’d like to add?

AngioWellness has become an important part of my practice; I believe it helps me to enhance patient care by enabling me to detect disease earlier, while also creating a new stream of revenue for my practice. Incorporating AngioWellness into my practice has been a win for my patients and my practice. OM