Surgical Modifiers

 CPT Modifier  :  50

Description :Bilateral Procedure: Unless otherwise identified in the listings, bilateral procedures that are performed at the same operative session should be identified by adding the CPT modifi er 50 to the appropriate five digit code. 

Report such procedures as a single line item with a unit of 1. For example, when CPT code 19303 (Mastectomy, simple, complete) is performed bilaterally, report the service as 1930350 (CPT code/modifier). 

If a procedure is identified by the terminology as bilateral (or unilateral or bilateral), do NOT report the procedure code with CPT modifier 50. For example, CPT code 68810 to 68815, (probing of nasolacrimal duct, with or without irrigation, unilateral or bilateral) includes terminology which indicates the procedure is performed either unilaterally or bilaterally. Therefore it’s not appropriate to report this modifier with this code. 

Additionally some procedure codes, i.e., CPT code 52000 (Cystourethroscopy, separate procedure) should NOT be reported with the 50 CPT modifier since anatomy does not permit this procedure to be performed bilaterally.

 CPT Modifier  :  51

Description : 

Multiple Procedures: When multiple procedures, other than E/M services, physical medicine and rehabilitation services or provision of supplies (e.g., vaccines), are performed at the same session by the same provider, the primary procedure or service may be reported as listed. The additional procedure(s) or service(s) may be identified by appending the CPT modifier 51 to the additional procedure or service code(s). 

Note: This modifier should not be appended to designated “add-on” codes. 

 CPT Modifier  :  53

Description : 

Discontinued Procedure: Under certain circumstances, the physician may elect to terminate a surgical or diagnostic procedure. Due to extenuating circumstances or those that threaten the well-being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. This circumstance may be reported by adding the CPT modifier 53 to the code reported by the physician for the discontinued procedure. 

CPT modifier 53 is used for “unusual (discontinued) circumstances”. Under certain circumstances, the physician may elect to terminate a surgical or diagnostic procedure due to extenuating circumstances that may threaten the well-being of the patient. In many instances, attachments, medical records, etc. are not required to be sent in if an explanation for the discontinuation is in the narrative field of the claim. For example, submit “discontinued due to elevated blood pressure”. When additional information to support the use of the 53 CPT modifier cannot be contained in the narrative of the claim, additional documentation may be submitted. 

Note: This modifier is not used to report the elective cancellation of a procedure prior to the patient’s anesthesia induction and/or surgical preparation in the operating suite. For outpatient hospital/ambulatory surgery center (ASC) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see CPT modifiers 73 and 74 (see modifiers approved for ASC hospital outpatient use) 

 CPT Modifier  :  54

Description : Surgical Care Only: When one physician performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding the CPT modifier 54 to the usual procedure code. Services billed with a 54 CPT modifier will be reimbursed at the intraoperative allowance for the surgical procedure. The intraoperative allowance includes the one day preoperative care, the intraoperative service, as well as any in-hospital visits that are performed.

 CPT Modifier  :  55

Description : Postoperative Management Only: When one physician performs the postoperative management and another physician has performed the surgical procedure, the postoperative component may be identified by adding the CPT modifier 55 to the usual procedure number. 

This modifier is used to identify postoperative, out of hospital medical care associated with a given surgical procedure. When billing for postoperative care only, report the original date of surgery as your date of service and the procedure code for the surgical procedure followed by the 55 CPT modifier. In rare situations where the out of hospital postoperative care is split between physicians, each physician must also indicate the period of his/her responsibility for the patient’s postoperative care by reporting the appropriate range of dates. Where a transfer of postoperative care occurs, the receiving physician cannot bill for any part of the global services until he/she has provided at least one service.

Scenario 3: Chest Pain

Chief Complaint 

• Chest pain

History 

• 70 year old female patient presents with complaints of chest pain that awoke her from sleep last night. Patient describes the pain as midsternal “tight, squeezing” and pressure in the epigastric region. Patient reports that the pain was accompanied by diaphoresis and lasted approximately 5-10 minutes before spontaneously resolving. Patient states she tried sitting up, walking, and taking some liquid antacid but experienced no relief with these measures. Denies change in diet, or any unusual foods yesterday. 

• She also reported experiencing some intermittent attacks of chest pain and tightness approximately 2-3 times over the last six months, that previous episodes were shorter in duration with less severe pain, and usually occurred when she was “emotional” or “tired”. Pain with prior episodes was relieved by rest. 

• Recent widowed status – husband died seven months ago; states increasing anxiety and difficulty sleeping. 

• Medical history significant for hypertension and hyperlipidemia. Negative for stroke, myocardial infarction, bleeding disorders, GERD, anxiety, and depression. 

• Social history: Nonsmoker, occasional social drinking, denies illicit drug use. She only engages in sedentary activities at this time. 

• Family history: Father died of heart attack at age 50, mother is 95 years old and in good health, two siblings both in good health, otherwise negative family history. 

• Influenza and pneumococcal immunizations up to date. No known allergies.

• Current medications: Hydrochlorothiazide and atorvastatin; Denies OTC medications. 

• Comprehensive review of systems negative for significant symptoms.

Exam 

• T: afebrile, P 90, R 16, BP 160/94 (sitting) 128/78 (lying), 132/82 (standing) Ht: 68in. Wt: 201 lbs BMI: 30.6 (obese)

• HEENT & NECK: normal to exam. 

• CHEST: Clear to exam 

• CV: RRR without murmur, gallop, or rub, No JVD. Carotids clear bilaterally. 

• PERIPHERAL VASCULAR: Skin warm and dry with good pulses to all extremities. No edema bilaterally. 

• ABDOMEN: normal to exam. 

• NEURO: Patient A&Ox3. Moves all extremities well.

Assessment and Plan 

• Worsening neuropathy with foot ulcer and slow healing shin wound. 

• Will debride and treat wounds here and refer to Wound Care Center for ongoing care and management. 

• Discussed importance of foot care, and the need to routinely inspect lower legs and bottoms of feet because of the bilateral peripheral neuropathy. 

• Counseled patient about the importance of tight, stable glycemic control to slow the progression of neuropathy and nephropathy; advised to keep a log of his blood sugars for two weeks for our review. 

Summary of ICD-10-CM Impacts 

Clinical Documentation 

1.Angina, acute coronary syndrome and post-infarction angina are classified under Ischemic Heart Disease. The subsection for angina disorders is now titled “angina pectoris,” the subsection for acute coronary syndrome is now classified as “other acute ischemic heart disease,” and the subsection for post-infarctional angina is now categorized as “certain current complications following myocardial infarction”. This last selection would be used in conjunction with a code from the category of acute myocardial infarction or the category of subsequent myocardial infarction, if applicable. 

2.Angina without coronary atherosclerosis requires documentation regarding specific characteristics such as stable, unstable, or the presence of spasm. In this example, angina pectoris, unspecified is coded as the information in the medical record is insufficient to assign a more specific code. “Other” [forms] is used when the information in the medical record provides detail for which a specific code does not exist. For example, there is no specific code for angina decubitus in ICD-10-CM, as is the case in ICD-9-CM. Angina decubitus is reported with the code for other forms of angina pectoris. 3.Additional differences to note when documenting cases of angina alone in ICD-10-CM include:

 • Unstable angina encompasses the older terms intermediate coronary syndrome and pre-infarction syndrome. 

• Prinzmetal angina and variant angina are coded as angina pectoris with documented spasm.

 4.In ICD-10, hypertension has undergone a definitional change. It is defined as essential (primary) and the concept of “benign or malignant” as it relates to hypertension no longer exists.

Coding

ICD-9-CM Diagnosis Codes

413.9     Other and unspecified angina pectoris 

401.9     Essential hypertension, unspecified 

272.4     Other and unspecified hyperlipidemia 

278.00   Obesity, unspecified 

V85.30  Body mass index (BMI) 30.0 – 30.9, adult

ICD-10-CM Diagnosis Codes

I20.9     Angina pectoris, unspecified 

I1Ø       Essential (primary) hypertension 

E78.5    Hyperlipidemia, unspecified

E66.Ø9 Other obesity due to excess calories 

Z68.3Ø Body mass index (BMI) 30.0- 30.9, adult

Other Impacts 

No specific impact noted.

Abbreviations related to Eye

A : Applanation tension AA : Amplitude of accommodation AACG : acute angle closure glaucoma ABK : aphakic bullous keratopathy ABMD : ant. basement membrane dystrophy cornea 371.52 AC : anterior chamber  AC/A : accomodative convergance/accommodation ratio ACA : anterior cerebral artery acc : accommodative ACG : angle closure glaucoma ACIOL anterior chamber intraocular lens ACS anterior cortical ACT lternate cover test(ACT' = near) add Added power for near vision AES anterior eye segment AET alternate esotropia AFGE air fluid gas exchange AFIP armed forces institute of pathology AHC acute hemorrhagic AHF anterior hyaloid face AHM anterior hyaloid membrane AION ant. ischemic optic neuropathy AK astigmatic keratotomy AKC allergic keratoconjunctivitis AL axial length ALK automated lamellar ALT argon laser trabeculoplasty AMD age related macular degeneration AMPPE acute multifocal placoid pigmaent epitheliopathy AMT amniotic membrane ANS autonomic nervious system Ant Vit anterior vitrectomy AO american optical company AO-HRR American Optical's Hardy-Rand-Rittler color vision plates APCT alternate prism & cover test APD afferent pupillary defect App applanation tonometry Appl applation tension AR axenfeld-reiger syndrome AR autorefractor ARC abnormal retinal correspondence ARG Angle recession glaucoma ARM age-related maculopathy ARMD age related macular degeneration ARN acute re tinal necrosis ARNS atropine retinoscopy ASC anterior subcapsular cataract 366.13 (senile vs juvenile) ASCC anterior subcapsular cataract 366.13 (senile vs juvenile) ASO4 atropine AT applanation tonometry (measure IOP) AV  arteriovenous (nicking) (fundus) AXT alternate exotropia B Betoptic B4L Binkhorst 4-loop IOL BAO branch artery occlusion BC base curve BD Base-down prism BDR background diabetic retinopathy BFP binocular fixation pattern BI base-in prism BLR bilateral lateral rectus BMR bilateral medial rectus BO Base-out prism BRAO branch retinal artery occlusion BRC Blind Rehab Center BROS Blind Rehab Outpatient Specialist BRVO branch retinal vein occlusion BS blond spot BSCL bandage soft contact lens (per Dr McCarty 7/2004) BSS balanced salt solution BSV binocular single vision BU base-up prism BUT (tear) break up time BVA best-corrected visual acuity BVO branch vein occlusion 362.36 BVO branch vein occlusion C cornea C&F cell and flare C/D cup to disc ratio (part of OPTIC DISC exam) C/D cup to disc ratio C/F cell/flare(anterior chamber) C/N cyclogyl and neosynephrine C/S cornea sclera C3F8 Perfluoropropane gas CA corneal abrasion CACG chronic angle closure glaucoma (365.23 2004) CAG conjunctival autograft CAI's carbonic anhydrase inhibitors Cap capsule(anterior or posterior) CAT computer access training cat cataract Cat TRAB combined cataract-trabeculectomy cat.ext cataract extraction CB ciliary body CBB cilary body band cc with correction  CCF carotid cavernous fistula CCS carotid cavernous shunt CCT Computed coronal tomography CDCR canaliculodacryocystorhinostomy CE cataract extraction CF count fingers CF confrontation field CFFF criitical flicker fusion frequency CG ciliary ganglion CHA compound hypermetropic astigmatism (376.20 2004) CHRPE congenital hypertrophy of retinal pigment epithelium (743.56) 2004) CjDCR conjunctivodacryocystorhinostomy CL contact lens CME cystoid macular edem  CMG combinde mechanism glaucoma CN cranial nerve CNAG chronic narrow angle glaucoma CNDO congential nasolacrimal duct obstruction CNVM choroidal neovascular membrane (362.16) COAG chronic open angle glaucoma Conj conjunctiva CPC central posterior curve CPC gas permeable contacts CPEO crh. progres. ext. ophthalmoplegia CR chorioretinal (as in "CR scar" 363.30 CRA central retinal artery CRAO central retinal artery occlusion 362.31 CRET constant right esotropian (monocular per Dr Stephens 2004 378.01) CRRR corneal rust ring remover CRV central retinal vein CRVO central retinal vein occlusion (362.35) CSC,CSR central serous (chorio) CSM central, steady, maintained CSME clinically significant macular edema CSUM central, steady, unmaintained fixation CT cover test(CT' = near) CTL contact lens CUSUM central, unsteady, unmaintained fixation CV color vision CVF confrontation visual field Cx cylinder (in diopters), axis (in degrees) Cyl cylinder(astigmatism) (367.20) cyl cylinder D disc D diopeter, the unit of refractive power D distance, distance vision D/Q deep and quiet D-100 Farnsworth Panel D-100 color vision test D-15 Farnsworth Panel D-15 color vision test DA dark adaptation DCR dacryocystorhinostomy DD disc diameter DD disc diameter DDH dissociated double hypertropia DDVD double dissociated vertical deviation DES Dry Eye Syndrome DFE dilated fundus exam DHD dissociated horizontal Disp dispensed DM & NOU  dilate mydriacyl & Neo-Synephrine, both eyes DMVP disc, macula, vessels and periphery DOD dilate right eye DOS dilate left eye DR diabatic retinopathy DRS diabetic retinopathy study DVD dissociated vertical deviation E esophoria EBMD epithel. basement membrane dystrophy cornea 371.52 ECCE extracapsular cataract extraction EE external examination EKC epidemic keratoconjunctivitis EKF epikeratophakia EL endolaser ELISA enzyme-linked immuno-absorbent assay EMM epimacular membrane EMP epimacular proliferation Enuc enucleation EOG electrooculogram EOM (I) extraocular movements (intact) EOMB extraocular musle balance epi epithelium EPI epinephrine EPRP endopanretinal photocoagulation ERG electroretinogram ERM epiretinal membrane 362.56 (macular puckering) ERP early receptor potential ES esophoria ET esotropia ETDRS early treatment diabetic retinopathy study EW Edinger-Westphal EW extended wear contact lens EWSCL extended wear soft contact lens M macula M manifest refraction M/N mydracyl and neosynephrine MA microaneurysm MB muscle balance MCA middle cerebral artery MCE microcystic corneal edema MCT medial canthal tendon MDF Map-Dot-Fingerprint of cornea 371.52 (ABMD) MEWDS multifocal evanescent white dot syndrome MG marcus gunn defect (afferent pupillary defect) MGD Meibomian Gland Dysfunct. 259.9 MH macular hole (362.54) MLF medial longitudinal fasciculus MMG mixed mechanism glaucoma M/N in regards to dilation means mydriacyl (tropicamide) & neophenylephrine (phenylephrine) & there is usually a time written next to it when drops instilled MP membrane peeling MPP massive preretinal proliferation MPR massive preretinal retraction MR manifest refraction MR medial rectus MRD marginal reflex distance MS multiple sclerosis MVR massive vitreous retraction MVR microvitreoretinal needle knife N near NAG narrow angle glaucoma NDF neutral density filter test NdYAG neodymium yittrium-aluminum-garnet laser NE non-exudative (as in NE-ARMD 362.51) NFL nerve fiber layer NI no improvement NLD nasolacrimal duct NLP no light perception NMI no manifest improvement NO near point NPA near point of accomodation NPC near point of convergence NPDR non-proliferative diabetic retinopathy NR non-reactive NRC normal retinal correspondence NS nuclear sclerosis (366.16) NSC nuclear sclerotic cataract NTG normal tension glaucoma 365.89 NV near vision NVD neovascularization of the disc NVE neovascularization elsewhere NVG neovascular glaucoma 365.63 NVI neovascularization of the Iris OA overaction (eg. Muscle) OA IO overactive infeior oblique OA IO OU overactive inferior obliques, both eyes OA SO overactive superior oblique OA SO OU overactive supeior obliques, both eyes OAG Open angle glaucoma OCT optical coherence tomography (92135) OD right eye ODM ophthalmodynamometry OHT ocular hypertension OKN optokinetic nystagmus O-M orientation and mobility ON optic nerve onh Optic Nerve Head ONSD optic nerve sheath decompression OR over-refraction ortho. orthophoria OS left eye OT ocular tension (pressure) OT ocular tension OT orthotropia OU both eyes OWS overwear syndrome

F + F fix and follow vision F&C flare & cells F&F fixes and follows FA fluorescein angiogram FAX fluid-air exchange FB foreign body FBS foreign body sensation FC finger counting FEF frontal eye field FEM fast eye movements FEVR familial exudative vitreoretinopathy FFA fundus fluorescein FFF flicker fusion frequency fields FGX fluid-gas exchange FK flilamentous keratitis FM 100 Farnsworth-Munsell 100-hue color vision test FP fibrous proliferation fpa far point of accommodation FTA fluorescent treponema absorption test FTC full to confrontation visual fields FTFC full to finger counting FTG full-time glasses FTO full-time occlusion FTP full-time patch GAT Goldman Applanation Tonometry GHPC giant helicoid peripapillary choroidpathy GPC giant papillary conjunctivitis gtt drop gtts drops GVR goldman visual field H hyperphoria HCL hard contact lens heme hemorrhage HGC horizontal gaze center HK herpes keratitis HM hand motions HOT hypotrophic HOTV HOTV vision test HRC high risk characteristic HRR Hardy Rand Rittler color plate HSK herpes simplex keratitis HSV herpes simplex virus HT hypertrophia HVF Humphrey Visual Field HZO herpes zoster ophthalmicus I iris I & A irrigation and aspiration IC infeior colliculus ICCE intracapsular cataract surgery ICD intercanthal distance ICE iridocornea enodthelial (syndrome) IK intersitiial keratitis ILM internal limiting membrane INO internuclear ophthalmoplegia IO inferior oblique IOFB interocular foreign body IOL intraocular lens ION ischemic optic neuropathy IOOA inferior oblique muscle overation IOP intraocular pressure IOP intraocular pressure IP intraoccular pressure IPCV idiopathic polypoidal IPD interpupillary distance IR inferior rectus IRMA  intraretinal microvascular abnormalities IVFA intravenous fluorescien angiography J1 : Jaeger near reading acuity J2, J3, etc jaeger size print JXG juvenile xanthogranuloma K keratometric cornea readings K cornea K (xx.xx/xx.xx) keratometry (measurements of cornea) K sicca keratoconjunctivitis sicca KCS keratoconjunctivitis sicca KM kermatomileusis KP keratic precipitates L left L lens L.L.c.P light perception with projection L/A lids and adnexa L/I lens iris LA light adaption Lac laceration LASER Light Amplification by Stimulated Emission of Radiation LASIK laser in situ keratomileusis LCT lateral canthal tendon LD lattice degeneration LDVD left dissociated vertical deviation LE left esophoria LE left eye LE(T) intermittent left esotropia LET left esoptropia LGB lateral geniculate body LGN lateral geniculate nucleus LH(T) intermittent left hypertropia LHT left hypertropia LI laser iridotomy LID left inferior oblique LIR left inferior reectus LK lamellar keratoplasty LKP lamellar keratoplasty LL lower lid LLL left lower lid LMR left medial rectus LOM lens opacity meter LP light perception LP + P light perception and projection LPCA long posterior cillary artery LPI laser peripheral iridectomy LPw/P light perception with projection LR lateral rectus LSO left superior oblique LSR left superior rectus LTG low tension glaucoma LTP laser trabeculoplasty LTP laser trabeculoplasty LUL left upper lid LV low vision LVA low vision aids LX(T) intermittent left exotropia LXT left exotropia T ocular tension (pressure) T tension TA applanation tonometry(eye pressure) TAC teller acuity cards TAP tension by applation Tapp Applation tonometry TBT tear break up time TBUT tear break up time TM trabecular meshwork TN tension (ocular) TOV transcient obscuration of vision TP tono-pen (eye pressure) Tp tension by pneumotonometry Tpen tonopen, method used to perform tonometry (checking intraocular pressure) TPI treponema pallidum immobilization test Tpn tension by pneumotonometer TPPL trans pars plana lensectomy TPPV trans pars plana vistrectomy Trab trabeculectomy TRD total or tractional retinal detachment TRIC trachoma or inclusion conjunctivitis Ts tension Schiotz TSCPC transsleral cyclophotocoagulation Tx treatment TX trabeculectomy UA underaction (eg. Muscle) UA IO underactive inferior oblique UA IO OU underactive infeior obliques, both eyes UA SO underactive superior obliques UCUSUM uncentral unsteady unmaintained fixation UGH uveitis glaucoma hyphema syndrome UL upper lid UPECCE unplanned extracapsular cataract extraction V vitreous VA visual acuity VA wc or cc visual acuity with correction VA sc visual acuity without correction VECP visual evoked cortical potential VEP visual-evoked potential VER visual evoked response VF visual fields(confrontation; automated) VGC vertical gaze center VH vitreous hemorrhage VISC vitreous infusion suction Vit vitrectomy; vitreous vit. vitreous infusion suction VKH vogt-koyanaki-harada VOD vision right eye VOR vestibulo-ocular reflex VOS vision left eye VOU vision both eyes W wear (present glasses) W4D Worth 4-dot test WGOA wearing glasses on arrival WTR wearing patch on arrival

P periphery(fundus) P pupil P + C prism and cover test PACG primary angle closure glaucoma PACT prism and alternate cover PAG perennial allergic conjunctivitis PAM potential acuity meter PAN periarteritis nodosa PAS peripheral anterior synechiae PAT prism adaptation test PBI pritein bound iodine PBK pseudophakia bullous keratopathy PC posterior chamber  PC peripheral curve PC post-cycloplegic PC Posterior capsule PC posterior chamber PC poserior commissure PCA posterior cerebral artery PCF pharyngoconjunctiival fever PCIOL posterior chamber intraocular lens PCIOL posterior capsule PCO posterior capsule opacity PD interpupillary distance PDG pigmetary dispersion glaucoma PDR proliferative diabetic retinopathy (250.5X + 362.0X) pdt photodynamic therapy (67221, 67225) PE phacoemulsification PED retinal pigment epithelial detachment PED persistent epithelial defect PEE punctate epithelial eorsion PEO progressive external ophthalmoplegia PERRLA  pupils equal round reactive to light accommodation PEX pseudoexfoliation syndrome 366.11 PF pred forte PFCL perfluorocarbon liquid PFV persistent fetal vascularture PGC pontine gaze center PH pin hole Phaco phacoemulsification PHM posteior hyaloid membrane PHNI pinhole: no improvement PHPV persistent hyperplastic of primary vitreous PI peripheral iridectomy PK penetrating keratoplasty PKP penetrating keratoplasty PKU phenylketonuria PL plano PLCO posterior lens capsule opacity PLS posterior lip sclerectomy PLT perferential looking technique PMMA polymethymetacrylate PMR POAG primary open angle glaucoma POHS presumed ocular histoplasmosis syndrome POZ posterior optical zone PP pars plana PP pars Pplicate PP near point PPA perpapillary atrophy PPA near point of accomodation PPC near point of convergence PPDR preproliferative diabetic retinopathy PPG pilopine gel PPL plar plana lensectomy PPMD posterior polymorphous dystrophy PPRF pontine paramedian reticular formation PPV pars plana vitrectomy PR pneumatic retinopexy PR far point of accommodation prba Problems-Risks-Benefits-Alternatives PRK photorefractive keratectomy PRP panretinal photocoagulation PRRE pupils round, regular and equal PS posterior synechiae PSC posterior subcapsular cataract PSCC posterior subcapsular cataract 366.14 or 743.31 PTK phototherapeutic keratectomy PTN pretectal nucleus PTO part time occlusion (patch) PTP part time patch PTR pterygium PVD posterior vitreous detachment 379.21 PVR proliferative vitreoretinopathy PXE pseudoexamthoma elasticum 757.39 in 2004 PXF pseudoexfoliation  PXG pseudoexfoliation glaucoma 365.52 PXS psedoexfoliation syndrome R right R retinoscopy R recession (of extraocular muscle) R refraction R & R recess and resect (muscle) R&R recess and resect (recess-resent) R/R resection and recession RA react to accommodation RAPD reverse afferent pupillary defect RB retinoblastoma RBAC Risk-Benefits-Complications-Alternatives RBCA Risk-Benefits-Complications-Alternatives Rc cycloplegic retinoscopy RD retinal detachment RDE random dot esterogram RDVD right dissociated vertical deviation RE right esophoria RE right eye RE(T) intermittent right esotropia Ref refraction REM rapid eye movements RET retinsocopy RET right esotropia ret pig retinitis pigmentosa RGP rigid gas permeable contact lens RH(T) intermittent right hypertropia RHT right hypertropia RIO right inferior oblique RIR right inferior rectus RK radial keratotomy RLF retrolental fibroplasia RLL right lower lid RLR right lateral rectus ROP retinopathy of prematurity RP retinitis pigmentosa RPA retinitis punctata albesens RPDE retinal pigment epithelium detachment RPE retinal pigment epithelium RPED retinal pigment epithelium detachement RRD rhegmatogenous retinal detachment RSO right superior oblique RSR right superior rectus RUL right upper lid RVO retinal vein occlusion Rx prescription (glasses) Rx right exophoria RX(T) intermittent right exotropia RXT right exotropia S sphere S(T) intermittent esotropia at distance SAC seasonal allergic conjunctivitis SB scleral buckle SBP scleral buckling procedure SBV single binocular vision sc without correction SC senile cataract SCH subconjunctival hemorrhage SCL soft contact lens SCT single cover test SEM slow eye movements SEM scanning electron microscopy SF scleral fixation SF6 sulfur hexafluroide (gas) SFP simultaneous foveal perception SG Sheridan-Gardner visual acuity test SI sector iridectomy SITA Swedish Interactive Thresholding Algorithm SK striate keratopathy SLE slit lamp exam SMD senile macular degeneration SMP simutaneous macular perception SO silicone oil SO superior oblique SO sympathetic ophthalmia SO superior oblique SOF superior orbital fissure SOI silicone oil injection SOV superior opthalamic vein SPCA short posteior ciliary artery SPCT simutaneous prism & cover test Sph sphere SPK superficial punctate keratopathy SR superior rectus SRF subretinal fluid SRH subretinal hemorrhage SRK Sanders, Retzlaff, Kraff formula for IOL power SRM subretinal membrane SRN subretinal neovascularization SRNVM subretinal neovascular membrane SRNVM subretinal neovascularization SS scleral spur SS scleral spur SSPE subacute sclerosing panencephalitis ST esotropia at distance ST esotropia at near