Luminopia Inc.

How To Prescribe

Prescribing Luminopia is as simple as prescribing an eye drop.

Order a Starter Kit

Get all the materials you'll need to begin prescribing Luminopia including Patient Brochures, Enrollment Forms and Prescribing and Coding Guides.

Prescription and Fulfillment process managed through PhilRx Pharmacy

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step 1

Fax or send eRx through EHR to PhilRx pharmacy. Parents receive enrollment text from PhilRx.

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step 2

PhilRx identifies coverage, processes Prior Authorizations and collects payment from patient.

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step 3

Access code is sent electronically to parent. Loaner headset shipped directly to patient’s home if needed.

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step 4

Once on therapy, physicians can virtually monitor adherence and follow-up with patients as normal practice.

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step 5

Upon therapy completion, headset is returned to Luminopia with prepaid return label.

What to include in Rx

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Patient Name & DOB

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ICD-10 Code for Amblyopic Eye

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Prescribed dose (1 hour per day, 6 days per week)

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Number of monthly refills (6-12 recommended)

If Prior Authorization is needed, PhilRx will pre-populate PA forms with information from the Rx and send you the CoverMyMeds key to complete and submit

Monitor Your Patients’ Adherence

Using the Luminopia Adherence Portal you can now follow along with your patients' amblyopia treatment. PhilRx will share your patients' access codes for you to see weekly and overall adherence trends for each of your patients.

Luminopia Adherence Portal

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CPT Codes When Educating Patients or Monitoring Adherence

CPT CodeRemote Therapeutic Monitoring Code Descriptors
98975Patient Set-Up/Education On Use of Medical Device By Clinical Staff (Luminopia Patient Education Video Available Online For Reference)
98980Remote Therapeutic Monitoring Treatment Management Services, Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive Communication With The Patient/Caregiver; First 20 Minutes
98981Remote Therapeutic Monitoring Treatment Management Services, Physician/Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least One Interactive Communication With The Patient/Caregiver; Each Additional 20 Minutes

CPT® is a registered trademark of the American Medical Association. All rights reserved. The AMA assumes no liability for data contained or not contained herein. Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and special billing requirements.

Resources

Prescribing & Coding Reference

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Electronic Enrollment Forms

Download

Patient Education Video

Luminopia Adherence Portal

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Appeal a denial for a specific patient with this template

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Ask health plans to cover Luminopia with this template

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Indications, Safety and Warnings

Indications:

Luminopia is a software-only digital therapeutic designed to be used with commercially available Head-Mounted Displays (HMDs) which are compatible with the software application. Luminopia is indicated for improvement in visual acuity in amblyopia patients, aged 4-7, associated with anisometropia and/or with mild strabismus, having received treatment instructions (frequency and duration) as prescribed by a trained eye-care professional. Luminopia is intended for both previously treated and untreated patients; however, patients with more than 12 months of prior treatment (other than refractive correction) have not been studied. Luminopia is intended to be used as an adjunct to full-time refractive correction, such as glasses, which should also be worn under the HMD during Luminopia therapy. Luminopia is intended for Prescription Use Only, in an at-home environment.

Safety:

In the Luminopia pivotal trial, 14 patients (25%) experienced adverse events in the treatment group vs. 8 (14%) in the control group. Ocular AEs were reported in 6 (11%) patients in the treatment group and 8 (14%) patients in the control. No serious adverse events (AEs) were reported. The most frequent non-serious AE potentially related to Luminopia was headache (14.3%), for which all cases were graded as mild, transient, and resolved without sequelae.

Warnings:

Rx only: Federal law restricts this device on the order of a trained eye-care professional.

Safety and effectiveness of Luminopia beyond 12 weeks is unknown. The long-term effects of HMD use in patients 4-7 years of age are unknown. Patients with a history of light-induced seizures, or serious medical conditions, should contact a doctor before using Luminopia. Patients should only use Luminopia while wearing their prescribed glasses under the HMD. Patients should stop using Luminopia and contact a doctor if they experience a new or worsened eye-turn, or double vision. Patients with an interpupillary distance of less than 52 mm should not use Luminopia.

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