FEB 02, 2016
CPT code for vitrectomy with silicone oil removal
Question: The physician performed a vitrectomy and also removed silicone oil. We billed CPT codes 67036 and 67120; however we were only paid for CPT code 67120. Before we appeal, can you confirm if we billed this claim correctly?
Answer: CPT code 67036 PPV vitrectomy and CPT code 67120 Removal of implanted material, posterior segment; extraocular are bundled together. The appropriate way to bill this service is only CPT code 67036, since vitrectomy instruments were used to remove the silicone oil. It is best to have a phone review or submit a corrected claim.