Riboflavin 5'-phosphate eye drops (Epioxahd/Epioxa formulation) for corneal cross-linking, up to 2 milliliters

Riboflavin 5'-phosphate ophthalmic solution is a photosensitizing agent used in corneal cross-linking (CXL) procedures to treat progressive keratoconus and corneal ectasia. The drug is applied topically to the corneal stroma, where it acts as a photosensitizer activated by ultraviolet-A (UVA) light to create covalent bonds between collagen fibrils, halting corneal thinning and steepening. This code covers the pharmaceutical agent specifically (Epioxahd/Epioxa formulations), billed per procedure session up to 2 mL.

This code applies when riboflavin 5'-phosphate solution is administered during an epithelium-off (epi-off) or epithelium-on (epi-on) corneal cross-linking procedure for documented progressive keratoconus or post-refractive surgery ectasia. Supporting documentation should include topographic evidence of progression, corneal pachymetry measurements, and the operative report confirming riboflavin instillation. Bill this code in conjunction with the appropriate CXL procedure code (e.g., CPT 0402T or 65785) for the complete service.

• Do not confuse with riboflavin formulations used in other CXL protocols (e.g., VibeX Rapid/Peschke); payers may require the specific brand name Epioxahd or Epioxa to be documented, as formulary coverage varies by product.
• This is a drug supply code billed separately from the surgical procedure; verify payer policy, as some commercial payers bundle the drug into the facility or procedure payment and will not reimburse it separately.
• Quantity is limited to up to 2 mL per session regardless of actual volume used; do not bill multiple units for a single cross-linking session, and ensure the operative note documents the drug name, concentration, and volume administered.