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Atlantic Posted Wed 16th of February, 2011 20:00:23 PM

When an excision of Pteryguim with amniotic membrane is performed, how should this be billed with the coding update for 2011 ?
65426 for excision, 65779 for placement of amniotic membrane (includes the membrane?) and V2790 membrane ?

SuperCoder Answered Fri 18th of February, 2011 09:07:47 AM

Check the details to differentiate between 65778, 65779, and 65780 as discussed below update and code accordingly with 65426 and V2790 (Amniotic membrane for surgical reconstruction, per procedure) for the supply of the donor tissue.
Please let me know if you have any denial related to this issue.

New code 65778 (Placement of amniotic membrane on the ocular surface for wound healing; self-retaining) describes a procedure in which amniotic membrane is placed on the ocular surface similar to what you do with a contact lens. “The membrane can sit on the eye for several days while the eye is healing,” explained George A. Williams, MD, American Academy of Ophthalmology, AMA/Specialty Society Relative Value Scale Update Committee (RUC) Member in the symposium’s “Ophthalmology” session co-presented with L. Neal Freeman, MD, MBA, CCS-P, FACS, American Society of Ophthalmic Plastic and Reconstructive Surgery, AMA CPT Advisory Committee Member. Code 65779 (Placement of amniotic membrane on the ocular surface for wound healing; single layer, sutured) is the same process but with suturing, which makes it fundamentally a different process.
You’ve had 65780 (Ocular surface reconstruction; amniotic membrane transplantation, "multiple layers") [emphasis added] for awhile, but CPT 2011 makes its distinction clear – that the transplantation of the amniotic membrane involves multiple layers. If the ophthalmologist uses tissue glue to attach the membrane, you should instead use 66999 (Unlisted procedure, anterior segment of eye). “Use this code for intentionally gluing, not what a child could do,” Williams stressed.

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