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Frequently Asked Questions About SPECTRALIS® OCT

  1. Is there wide field imaging on the 2 mode version of the Spectralis?
  2. If I purchase the 2 mode version, will I be able to upgrade to the 6-mode HRA+OCT at a later date?
  3. How many billing codes are applicable to the 2 mode Spectralis?
  4. How can I accentuate the definition of the vitreo-retinal interface?
  5. How can I adjust the space between B-scan slices in a volume scan?
  6. How can I change the size of a volume scan?
  7. How do you print multiple OCT images from a volume scan?
  8. How do I turn off the Eye Tracking ART™ (Automatic Real-Time) software on the SPECTRALIS®?
  9. How do I print a combined RNFL circle scan and posterior pole scan on the same printout?
  10. How do I print a posterior pole OU report?
  11. What is the proper billing code for OCT/HRT procedures? I have been having trouble with billing OCT and HRT posterior eye exams. The insurance companies tell me the code I am using (92135) is no longer valid.
  12. I am noticing a significant decrease in payments on my OCT and HRT billings. Can you explain this?
  13. What are the main differences between the SPECTRALIS OCT and the SPECTRALIS OCTplus ?
  14. How many configurations or models of SPECTRALIS are available?
  15. How do I set a reference on a Baseline OCT?
  16. How do I safely clean my lens?

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  1. Is there wide field imaging on the 2 mode version of the Spectralis?

    Yes. The 55° lens and the Staurenghi lens (150°) can be used with any of the Spectralis units. The 2-mode version also has the Automatic Real Time (ART) software that allows you to paint the retina on the screen in real time. Because of the movable scan head, the Spectralis allows you to create a quick montage out to 100° with no post-processing.

  2. If I purchase the 2 mode version, will I be able to upgrade to the 6-mode HRA+OCT at a later date?

    Yes. The 2 mode and 5 mode version can be upgraded to the 6 mode HRA+OCT.

  3. How many billing codes are applicable to the 2 mode Spectralis?

    There are two applicable codes:
    92135 – Optical Coherence Tomography
    92285 – External Ocular Photography

  4. How can I accentuate the definition of the vitreo-retinal interface?

    To accentuate the definition of the vitreo-retinal interface, try adjusting the contrast on the image. To do this, open the image, then click the half white/half black circular button at the top left hand side of the screen.

    This opens the contrast adjustment window. In this window, slide the OCT contrast bar to adjust the image.

  5. How can I adjust the space between B-scan slices in a volume scan?

    To increase (or decrease) the number of B-scans and thereby decrease/increase the space between scans in any volume scan, enter the acquisition mode, select the scan pattern and then roll the mouse wheel OR press [Shift] + the up (or down) arrow key.

    You can also increase (or decrease) the height of the volume scan by using the arrow keys without the shift key.

  6. How can I change the size of a volume scan?

    To increase (or decrease) the volume scan height or width, select “volume” on the touch panel when in OCT mode then press the arrow keys on the keyboard.

    You can also increase (or decrease) the B-scan density in any volume scan by rolling the mouse wheel OR by pressing [Shift] + the up (or down) arrow key.

  7. How do you print multiple OCT images from a volume scan?

    To print multiple OCT images from a volume scan, begin by right-clicking on the volume icon and selecting "expand." Double left-click to open one of the "expanded" images. Use the right and left arrow keys on the keyboard to skip to each image in the series and press the down arrow key to put an individual image in the Lightbox. Close the expanded image and highlight the images in the Lightbox. Right-click on one of the highlighted images and select "print" from the context menu. Select the option “16 images per page”. Select “print”.

  8. How do I turn off the Eye Tracking ART™ (Automatic Real-Time) software on the SPECTRALIS®?

    The ART Eye Tracking feature can only be turned off in volume scans.

    To turn off the tracking software:
    1. In the acquisition mode, press these touch panel buttons in sequence: [OCT] then [IR+OCT] then [Volume]
    2. With the mouse, single-click the [ART] button (bottom right-hand corner of the acquisition window), so the button is depressed.
    3. When the OCT image is correctly oriented in the acquisition window, press the touch panel [Acquire] button.

    Each saved image is tagged in the bottom, right-hand corner with image information including the ART settings for that image. If "ART" is in the tag, the ART Eye Tracking software was active for that image. The "ART" tag will be followed by a number in parenthesis which indicates the ART setting (how many B-scans were averaged). If the image does not include the "ART" tag, the tracking software was not activated and no B-scans were averaged.

    To view the detailed image information:
    - Open an OCT image and select "image" at the top of the screen
    - From the dropdown menu, select "Image information"
    - The "ART Mode" settings will be noted in the "OCT Image" section

  9. How do I print a combined RNFL circle scan and posterior pole scan on the same printout?

    a. Open a patient file and select the “Image Window” view.

    		 
    b. Drag the desired RNFL circle scan and the posterior pole scan from the same eye down into the
    lightbox area.

    c. Select both images by holding down the Ctrl key on the keyboard and
    left-clicking on both images.

    d. Right click on one of the highlighted images and select “Print” from the
    dropdown menu.
    e. Select “RNFL & Asymmetry Analysis Single Exam Report” from the “Reports”
    section of the “Print Spectralis Report” pop-up window.
    f. Click on the “Print” button and you will print the adjacent report. a. Open a
    patient file and select the “Image Window” view.

  10. How do I print a posterior pole OU report?

    a. Open a patient file and select the “Image Window” view.
    b. Drag the desired Posterior Pole scan from each eye down into the lightbox
    area.

    c. Select both images by holding down the Ctrl key on the keyboard and
    left-clicking on each image.
    d. Right click on one of the highlighted images and select “Print” from the
    dropdown menu.
    e. Select “Asymmetry Analysis Single Exam Report OU” from the “Reports” section
    of the “Print Spectralis Report” pop-up window.
     f. Click on the “Print” button and you will print the adjacent report.
       
       
       
       

  11. What is the proper billing code for OCT/HRT procedures? I have been having trouble with billing OCT and HRT posterior eye exams. The insurance companies tell me the code I am using (92135) is no longer valid.

    Effective January 1, 2011, the CPT code used for OCT and HRT billing 92135 (Scanning computerized ophthalmic diagnostic imaging, posterior segment, or “SCODI”) was replaced with two new codes:

    • 92133 – SCODI, Posterior segment, optic nerve
    • 92134 – SCODI, Posterior segment, retina

    Medicare reimbursement is the same for 92133 and 92134, and the 2011 unadjusted base rate for the two codes is 1% higher than the 2010 rate was for 92135.

    There is one very significant difference between the new codes and 92135. The new codes are designated as “unilateral OR bilateral” codes, so the payment amount stays the same even if both eyes are examined. The old code, 92135, was a unilateral code, so when both eyes were scanned the payment was twice the single eye rate.

    Click here for a listing of diagnostic imaging codes and payment information.

  12. I am noticing a significant decrease in payments on my OCT and HRT billings. Can you explain this?

    Effective January 1, 2011, the CPT code used for OCT and HRT billing 92135 (Scanning computerized ophthalmic diagnostic imaging, posterior segment, or “SCODI”) was replaced with two new codes:
    • 92133 – SCODI, Posterior segment, optic nerve
    • 92134 – SCODI, Posterior segment, retina

    Medicare reimbursement is the same for 92133 and 92134, and the 2011 unadjusted base rate for the two codes is 1% higher than the 2010 rate was for 92135.

    There is one very significant difference between the new codes and 92135. The new codes are designated as “unilateral OR bilateral” codes, so the payment amount stays the same even if both eyes are examined. The old code, 92135, was a unilateral code, so when both eyes were scanned the payment was twice the single eye rate.

    Click here for a listing of diagnostic imaging codes and payment information

  13. What are the main differences between the SPECTRALIS OCT and the SPECTRALIS OCTplus ?


    Like all models in the SPECTRALIS® family, both the OCT and the OCTPlus include the exclusive TruTrack™ active eye tracking, FoDi™(Fovea-to-Disc) alignment, and Heidelberg Noise Reduction™ technology. Both models of the SPECTRALIS deliver stellar images and the precise follow-up of AutoRescan™. The difference between the two systems is that the PLUS system is built on the HRA+OCT platform, so it is upgradable* and includes the panning camera head to facilitate Wide Field imaging. Take a look at the 7-Model Chart to see all the options.

    *SPECTRALIS OCTPLUS can be upgraded to include the following imaging modes: BluePeak™ blue laser fundus autofluorescence, Red-free, Fluorescein Angiography (high speed video), and ICG Angiography (high speed video).

  14. How many configurations or models of SPECTRALIS are available?

    The SPECTRALIS product family continues to grow, and there are now seven (7) SPECTRALIS models available in the US. In addition, because the SPECTRALIS platform is so versatile it is possible to order modified configurations of the available models. Take a look at the Model Chart, or check with your local sales representative to learn about all the options.

  15. How do I set a reference on a Baseline OCT?

    1. Acquire and save the OCT scan(s) of choice.
    2. Open the OCT.
    3. In the image window, right click on an image icon and select Progression > Set Reference.
    4. OR within an open image, select Progression from the menu bar and Set Reference from the drop down menu.

  16. How do I safely clean my lens?

    1. Remove the lens from the mount by turning counter clockwise.
    2. Use a blower brush to remove any loose particles.
    3. With a soft microfiber cloth, wipe gently in a circular manner beginning in the center of the lens and working your way out to the edge.
    4. If this does not clear the lens, it is best to use a few drops of pur (99.9%) ethyl alcohol on a microfiber cloth and repeat until the lens is clear.

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