1. A. Definitions

   1. Artificial Eye or Ocular Prosthesis—a replacement for a missing or damaged, unsightly eye.
   2. Full Ocular Prosthesis—used for individuals who have the globe removed allowing for the fitting of a regular artificial eye.
   3. Related Services—include polishing or resurfacing of ocular prosthetics, enlargements or reductions of ocular prosthetics, and fabrication or fitting of ocular conformer.

   4. Scleral Shell (or Shield)—

      1. a. a custom-made, thin ocular prosthesis fitted directly over a blind and shrunken globe. It includes the iris (the colored part of the eye) and the sclera (the white part of the eye);
      2. b. a term utilized to describe different types of hard scleral contact lenses. A shell fits over the entire exposed surface of the eye as opposed to a corneal contact lens which covers only the central nonwhite area encompassing the pupil and iris.
2. B. These procedures require prior authorization.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 30:2830 (December 2004), repromulgated 31:1598 (July 2005).