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67713 vs 67043 please advised on coding

louise Posted Mon 08th of April, 2019 08:59:00 AM
* 3-Port, 25G Pars plana vitrectomy * Membrane Peel * Endolaser * Fluid-Air exchange 67113 vs 67043 --- Traction retinal detachment , vitreous hemorrhage eye A 25G cannula loaded on a trocar was inserted 4 mm posterior to the limbus in the inferotemporal quadrant. The infusion line was placed through the cannula. The tip of infusion line was directly visualized to be in the correct space prior to the start of infusion. Two additional 25G cannulas loaded on trocars were inserted 4 mm posterior to the limbus at the 2 o’clock and 10 o’clock positions. Through the 2 superior cannulas, the endoilluminator and microvitrector were used to perform a core vitrectomy under the Resight wide-angle viewing system. The peripheral vitreous skirt was carefully trimmed for 360 degrees, relieving all anterior-posterior traction. Under high-magnification contact lens the microvitrector and endoilluminator were used to carefully segment the tractional bands as they emanated from the optic nerve. The gliotic tissue was cleared radially from the nerve by meticulous dissection. Residual tissue was then delaminated with the microvitrector. Endolaser was performed around 360 degrees in the periphery. Fluid-air exchange was performed. The 3 cannulas were removed and 2 sclerotomies were found to be self-sealing and the third one was closed with 7-0 vicryl suture. The intraocular pressure was palpated to be within normal limits. Subconjunctival injections ancef and solumedrol were given in the inferior cul-de-sac.
SuperCoder Answered Tue 09th of April, 2019 05:15:38 AM

Hi Louise,


Thanks for your question.


Since vitrectomy is performed in retinal detachment surgery, code 67113 is more appropriate. CPT guideline in code 67043 says “For use of vitrectomy in retinal detachment surgery, see 67108, 67113”.


Please feel free to write if you have any question.



louise Posted Mon 22nd of April, 2019 13:09:29 PM
Hi, Thanks, reading over the notes retinal detachment was not indicated. Is 67113 still appropriate to code?
SuperCoder Answered Wed 24th of April, 2019 02:07:06 AM

No, code 67113 should only be reported for retinal detachment. To report vitrectomy, pars plana approach, other than in retinal detachment surgery, please choose code from series 67036-67043.


Hope this helps.




louise Posted Fri 26th of April, 2019 09:10:09 AM
Thanks but I am torn btwn 67042 vs 67043 . Which one to use and why was that selected. I want to use 67042
SuperCoder Answered Mon 29th of April, 2019 03:45:41 AM

If the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He removes the internal limiting membrane of the retina to treat swelling of the macula or repair a hole in the macula. He may also inject air, gas, or silicone oil to stabilize the retina code 67042.


If the provider removes vitreous humor, the gelatinous material that gives shape to the eye, using a mechanical cutting tool. He then removes the subretinal membrane to treat excessive growth of new vessels that obstruct the vision, common in age related macular degeneration. He may also use air, gas or silicone oil to stabilize the retina and employ a laser beam to heal the damaged retinal tissues, if present then code 67043.


Hope this helps.



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