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Yag for pupillary membrane

Sherri Posted Tue 23rd of April, 2019 08:19:34 AM
We have a patient that has Pigmented pupillary membrane. The patient has never had cataract surgery. Our physician plans to use the Yag laser to break that up and hopefully restore part of his vision. CPT 66821 is not correct. Can you give advice on the proper code?
SuperCoder Answered Wed 24th of April, 2019 07:42:03 AM
Many providers use CPT 66600 for removal of affected pupillary membrane. As per the clinical responsibility of code 66600, the provider makes a small incision in the cornea. He then places a special magnification lens on the eye of the patient and directs laser beam through it to the iris. This laser beam excises a part of the iris and destroys the lesion on it. If your operative report documentation is matching with the CPT 66600 clinical responsibility, then code 66600.

 If operative report documentation does not match, then appropriate code will be 66999 (Unlisted procedure, anterior segment of eye). Also attach copy of operative report with bill to justify the claim.


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