louise Posted Thu 05th of March, 2020 13:17:08 PM
Please help to with what code fits best and why . Phacoemulsification with intraocular lens implantation and Kahook Goniotomy
ECP portion of the procedure. The sulcus was inflated with Provisc. The ECP probe was inserted into the anterior chamber through the main temporal wound. The ciliary processes were visualized and treated with the ECP laser for a total of 66 spots spanning approximately 180 degrees at a power. The ECP probe was then removed from the eye.
viscoelastic was removed with irrigation and aspiration .
SuperCoder Answered Fri 06th of March, 2020 06:10:21 AM
Thank you for your question.
In CPT® code 65820, the provider incises the limbus and enters the anterior chamber using a gonioknife. He then opens the trabecular meshwork, the tissue of mesh located where the iris meets the sclera, to drain the aqueous humor.
In CPT® code 66711, the provider makes an incision in the border of the cornea and sclera and then inserts a curved or straight endoscopic laser probe to gain access to the ciliary body. The laser endoscope incorporates an image guide, a light guide, and a semiconductor diode laser guide and is connected to a console that contains all the necessary instrumentation, including camera, light source, monitor, and recorder. The provider views the procedure through the monitor rather than the operating microscope. He continuously visualizes the movement of the laser probe and records the images using a video camera. Once he switches the probe on, the laser beam falls on the ciliary process which whitens and shrinks to reduce to reduce the intraocular pressure. He uses the video monitor to regulate the damage to the ciliary body. Finally, the provider closes the incision with sutures and administers a topical antibiotic to the eye and applies an eye pressure patch.
Note: Per NCCI Edit, code 65820 is a column 2 code for 66711, but you may use a CCI-associated modifier to override the edit under appropriate circumstances. Kindly check your detailed documentation to rule out the bundling between both the codes before final reporting.
Also, as per the above excerpt, the documentation is more towards the ciliary body destruction through ECP laser (Endocyclophotocoagulation), which counts toward code 66711.
Hope that helps!