AUG 14, 2020
Frequency of punctal plugs
Question: We have a patient requesting quick-dissolving plugs, which require reinsertion monthly. How often can we insert punctal plugs on a single patient?
Answer: First, check with the payer for their unique requirements. For example, First Coast policy L36232 indicates, “Long term (great than 90 days), slowly dissolvable punctal plugs may be an appropriate treatment for patients for whom silicone punctal plugs are contraindicated. Serial application of temporary plugs serves no useful clinical purpose.”
Documentation must support why additional plugs may be necessary. You can find Medicare Administrative Contractor policies at aao.org/lcds. Commercial payers post their policies on their webpage.
Learn more about dry eye in the Oculofacial module.