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Help with codes

louise Posted Mon 04th of November, 2019 06:35:12 AM
Scleral fixation IOL + Pars plana vitrectomy lt and Pars plana vitrectomy Pars plana lensectomy Scleral fixated intraocular lens placement RT 67036 vs 66984
SuperCoder Answered Tue 05th of November, 2019 07:19:52 AM

Hi,

As per the provided documentation, physician has performed scleral fixation IOL + Pars plana vitrectomy on left eye for which appropriate CPT codes will be 67036 and 66825.

However, on right side physician has performed pars plana vitrectomy, pars plana lensectomy and scleral fixation IOL, coding will depends on the amount of lens material removed and the method the ophthalmologist used to remove it.

Report 67036 (Vitrectomy, mechanical, pars plana approach), if the lens material had dropped to the back of the posterior chamber making a posterior vitrectomy necessary. If the lens material is small and removed by use of the vitrector, no separate code is used for its removal.

However, if the lens material is not far from its original position and only a partial posterior vitrectomy is necessary to remove it, report 66852 (Removal of lens material; pars plana approach, with or without vitrectomy), which includes both the vitrectomy and lensectomy.

For scleral fixation IOL add 66825 with 59 modifier.

 

Note: CPT 66984 is incorrect code as it is used for “extracapsular cataract removal with insertion of intraocular lens prosthesis”, but in provided operative note physician is not removing cataract.

 

Please also check below link:

https://www.supercoder.com/coding-newsletters/my-ophthalmology-coding-alert/you-be-the-coder-pars-plana-vitrectomy-138750-article

 

 

Hope this helps!

 

Thanks

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