Clinical Downloads & Documentation
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Clinical Downloads & Documentation
IFUs, sell sheets, billing guides, and clinical references for Aurora, Eclipse, and Tetra.
2024 Ophthalogix Billing Packet
Complete coding and reimbursement guide for Eclipse and Tetra procedures. CPT codes, ICD-10 pairings, documentation requirements, and payer-specific guidance.
CPT 65778 Reimbursement Guide
Focused guide for CPT 65778 (Aurora and Eclipse office-based application). Average reimbursement $827/eye, documentation checklist, and appeal language.
Prior Authorization Template
Pre-written prior authorization letter template for AMT procedures. Includes clinical necessity language and supporting literature references.
Aurora Clinical Overview Brochure
Clinical overview of Aurora — aperture design rationale, FORMULA/5™ processing, sizes, indications, and application summary.
Aurora Representative Sell Sheet
Physician-facing clinical reference for Aurora dehydrated amniotic membrane allograft. Covers the patent-pending central aperture design, FORMULA/5™ processing, ICD-10 indications, CPT reimbursement, and practice integration.
Download PDFProduct Comparison Card
Quick-reference comparison of Aurora, Eclipse, and Tetra — format, setting, size, CPT code, and best-fit indications on a single card.
Patient Education Sheet — AMT Explained
Plain-language patient handout explaining amniotic membrane therapy, what to expect during treatment, and post-procedure instructions.
Ophthalogix Order Form
Standard order form for Aurora, Eclipse, and Tetra. Includes product codes, quantities, and shipping instructions.
Informed Consent — Amniotic Membrane Placement
Clinically thorough patient consent form covering procedure overview, tissue sourcing, post-placement expectations, risks, alternatives, and signature blocks. Print-ready for the exam chair.
2026 Physician Fee Schedule — CPT 65778
Official CMS reimbursement data for amniotic membrane transplantation without sutures (CPT 65778). Use for billing verification, payer negotiations, and documentation support.
Download PDFTo request downloadable files, contact Ophthalogix directly.