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Frequently Asked Questions About SPECTRALIS® HRA+OCT

  1. How is the image alignment software on the SPECTRALIS®? different from other Spectral Domain systems?
  2. How can I accentuate the definition of the vitreo-retinal interface?
  3. How can I adjust the space between B-scan slices in a volume scan?
  4. How can I change the size of a volume scan?
  5. Will the HRA OCT software run on Mac OS 10.4?
  6. Is it possible to hand draw an area and get the area calculation/measurement ?
  7. How do I turn off the Eye Tracking ART (Automatic Real-Time) software on the SPECTRALIS?
  8. Can the Posterior Pole Asymmetry Analysis be used if only one eye is scanned?
  9. Is the diameter of the circle scan fixed or variable?
  10. How do I print a combined RNFL circle scan and posterior pole scan on the same printout?
  11. How do I print a posterior pole OU report?
  12. 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 The insurance companies tell me the code I am using (92135) is no longer valid.
  13. I am noticing a significant decrease in payments on my OCT and HRT billings. Can you explain this?
  14. How many configurations or models of SPECTRALIS are available?
  15. How can I copy patient records from one database and to another database?

If you do not see your question above, please contact us.

 


  1. How is the image alignment software on the SPECTRALIS®? different from other Spectral Domain systems?

    The SPECTRALIS is a dual beam confocal scanning system. The lasers are calibrated every time they are used to make sure they are aligned with each other. One laser captures the reference image and the other laser simultaneously captures the spectral domain OCT scan. The proprietary TruTrack software recognizes the retina and tracks it as the eye moves so that the same scan can be taken on subsequent visits.

  2. 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.

  3. 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.

  4. 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.

  5. Will the HRA OCT software run on Mac OS 10.4?

    Heidelberg Eye Explorer (HEYEX) software platform, which all Heidelberg Engineering instruments are based off of, is not compatible with Macintosh operating systems.

  6. Is it possible to hand draw an area and get the area calculation/measurement ?

    Yes, the area measurement can be displayed for a free hand drawing on an HRA image. Select the overlay that is a circle symbol (region overlay) and draw your region making sure that the end point meets at the small blue square that is created at your starting point. Right-mouse-click on the small blue square and choose “overlay properties” from the context menu. Check the box next to “Display area size in mm²” and select the “OK” button at the bottom. Note: this feature is only available on a single HRA fundus image or on simultaneously-acquired fundus images.

  7. 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

  8. Can the Posterior Pole Asymmetry Analysis be used if only one eye is scanned?

    Yes. The Posterior Pole Asymmetry Analysis compares retinal thickness of both hemispheres of an individual eye (single eye) and between the eyes (OU). While a two-eye analysis gives a more comprehensive picture, the single eye analysis can effectively highlight hemisphere asymmetry within a single eye.

    The Posterior Pole Asymmetry Single Exam Report combines a FoDi™-aligned, RNFL circle scan analysis with the hemisphere asymmetry analysis to give the clinician even more information in this single eye report.

  9. Is the diameter of the circle scan fixed or variable?

    The circle scan pattern is fixed at 12 degrees (see


    page 37
    of the SPECTRALIS User Guide).  However, the scan
    beam is refracted as it passes through the anterior eye tissue, so the size of
    the image in the saved scan varies based on the individual dimensions and
    properties of each eye. 

     

    The most significant factor affecting the size of the circle in the image is the
    radius of curvature of the anterior corneal surface (“C-Curve”). 


    Page 15
    of the SPECTRALIS User Guide describes how to enter a
    patient’s measured C-Curve value in the HEYEX Eye Data dialog box. 
    It also describes the basis for the default value of 7.7mm. 

     

    For stored circle scan images, the circle diameter (in mm) is provided in the
    Image Info
    box. 

    Page 53
    of the User Guide shows the screen icon to click to
    access this information.   

     

    The operator can change Eye Data values, including C-Curve, at any
    time.  Changing a C-Curve value will change the diameter measurement
    (displayed in the Image Info box) of all stored circle scans in
    that patient’s file.  

  10. 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.
  11. 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.
       
       
       
       
  12. 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.

  13. 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

  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 can I copy patient records from one database and to another database?

    1. If you have multiple Heidelberg Engineering instruments with separate databases, you can export a copy of patient records from one database and then import the records into the other database.
    2. To export patient records, load all desired patient records > right mouse click > select the instrument’s “Batch” > click Export as E2E
    3. To import patient records, select “Import E2E files” under the Database menu and select the E2E files you would like to import.
    4. Alternatively, you may want to consider networking your instruments to operate on a single, centralized database. For more information, please refer to the FAQs under “SPECTRALIS Networking” or “HRT Networking”.