louise Posted Thu 21st of November, 2019 07:25:40 AM
temporary keratoplasty , open sky extracapsular cataract extraction 66982 Penetrating keratoplasty (8.5 mm in 8.0 host) right eye 65730 vs 67610 . part II Pars plana vitrectomy
Pars plana lensectomy, Scleral fixated intraocular lens placement lt eye
SuperCoder Answered Fri 22nd of November, 2019 02:26:20 AM
Thank you for your question.
kindly send more details of operative report so that we get clarity on the codes that we must use.
Also, check with the code 67610 mentioned above, it a an invalid code and i guess you mean to say CPT 65710.
In the mean while,
Ask yourself these 4 questions when you're deciding whether to report 66982 or not:
- Is the pupil miotic?
- Is the patient very young, and still in the amblyogenic developmental stage?
- Does the IOL need extra support, such as permanent intraocular sutures or capsular tension rings?
- Does the ophthalmologist use dye to help him visualize the anterior chamber?
If the answers are "YES," you may be able to report 66982 instead of the lower-reimbursing 66984 (Extracapsular cataract removal with insertion of intraocular lens prosthesis ...) for an extracapsular cataract removal.
Watch out: Don't report 66982 just because the ophthalmologist encounters a surgical complication, such as the need to perform a vitrectomy. A true complex cataract extraction is prospectively planned based on pre-existing conditions.
Bottom line: Report 66982 only if the ophthalmologist knows preoperatively that a more complex procedure is necessary and meets the requirements of the code descriptor. Documentation in the medical record prior to the surgery will support this decision.
louise Posted Mon 25th of November, 2019 06:51:49 AM
Left eye - 2 superior cannulas, the endoilluminator and microvitrector were used to perform a core vitrectomy. The vitreous cutter was used on aspiration mode to induce a full posterior vitreous detachment in all quadrants.
The vitreous cutter was used to remove the lens. The peripheral retina was inspected around 360 degrees using scleral depression and the vitreous cutter was used to shave the peripheral vitreous.
A caliper set at 3 mm was used to mark the sclera 3 mm posterior to the limbus both superiorly and inferiorly 180 degrees apart. A 25g cannula was inserted superiorly and another one was inserted inferiorly at the aforementioned marks. A 2.75mm keratome was used to create a nasal clear cornea incision. A 3-piece IOL was inserted into the eye leaving the trailing haptic outside the eye.
Right eye --- anterior capsule was stained with vision blue , can opener technique used to open the capsule then hydrodissection use to pull the nucleus out of the bag , the PC was open and there was old vitreous hemorrhage it was left for the retina to clean the cortex
temporary keratoprosthesis sized 8.20 mm was sutured using 9-0 nylon to the sclera around the limbus with water tight fit
Attention was turned to the donor cornea. The cornea was placed in the punch endothelial side up.
The donor cornea was then trephined with a 8.5 mm trephine.
The donor button was covered with OptiSeal and placed aside.
louise Posted Wed 27th of November, 2019 06:39:36 AM
Reading over this you suggested 66982 for PPV, lensectomy ans scleral fixated intralocular placement. New to ophthalmology. This code can be used with any other Dx's other than Cataract?
SuperCoder Answered Wed 27th of November, 2019 14:15:29 PM
CPT 66982 is generally used with cataract only.
Also, If there is mention of word penetrating in your documentation which means thickness of donar cornea, indicating to its full thickness then we will go for cpt 65730. however, if there is mention of lamellar in documents which means thin layer and refers to outerlayer of the cornea then we will go for 65710. fell free to ask for any further question.