Age-Related Macular Degeneration (AMD) Treatment
Receipt of Services
VEHSS includes indicators on the percentage of people with diagnosed AMD who had a treatment claim from payment claims in administrative claims databases and medical record information in the IRIS Registry of electronic health records. VEHSS reports the percent of patients diagnosed with AMD who received at least one included treatment during the year of observation. Therefore, all prevalence estimates are based on a denominator of patients who had a visit during the calendar year that included an AMD diagnosis.
Anti–vascular endothelial growth factor (Anti-VEGF) Injection
Anti-VEGF injection procedures are identified among patients with diagnosed AMD based on the procedure, diagnosis, and national drug codes (NDC) listed below.
| Included Procedures | Procedure, Diagnosis and NDC Codes |
|---|---|
| Injection, aflibercept | J0178, J9400 |
| Injection, ranibizumab | J2778 |
| Injection, bevacizumab, unclassified injectable, or compounded drug | J9035, J3490, J3590, J7999, C9257, C9142, Q5107, or Q9977 AND claim has primary diagnosis of AMD OR includes 67028 |
| Intravitreal injection of pharmacologic agent | 67028 with anti-VEGF NDC (61755-005-02, 61755-005-55, 50242-080-02, 50242-0080-02, 50242-080-03, 50242-0080-03, 50242-060-01, 50242-060-10) |
The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims. See data source documentation.
Laser/photocoagulation therapy procedures are identified among patients with diagnosed AMD based on the procedure and diagnosis codes listed below.
| Included Procedures | Procedure Codes |
|---|---|
| Destruction procedures on the retina or choroid, photocoagulation | 67220 or G0186 |
The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims. See data source documentation.
Photodynamic Therapy
Photodynamic therapy procedures are identified among patients with diagnosed AMD based on the procedure and diagnosis codes listed below.
| Included Procedures | Procedure Codes |
|---|---|
| Destruction procedures on the retina or choroid, photodynamic therapy | 67221 |
| Destruction procedures on the retina or choroid, photodynamic therapy, second eye | 67225 |
| Verteporfin injection | J3396 |
The data sources available for this category include Medicare (default), IRIS Registry, Medicaid, Managed Vision Care, and MarketScan commercial insurance claims. See data source documentation.