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February 2007

Savvy Coder: Coding & Reimbursement
Medicare 2007: CPT Update
By Michael X. Repka, MD, OCS, Academy Secretry for Federal Affairs, Cherie McNett, Academy Director of Health Policy, and Sue Vicchrilli, COT, OCS, Academy Coding Executive

Is your practice up to date with the latest CPT changes? Along with an increase in your patient’s deductible from $124 to $131, there are some code changes that will directly affect Eye M.D.s.

Three New CPT Codes

In the Integumentary System section of CPT, there is a new code: 15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or 1 percent of body area of infants and children.

In the Eye and Ocular Adnexa section, a housekeeping change deletes CPT code 67350 Biopsy of extraocular muscle, giving the same description to a new code 67346.

In the Special Testing Services section, there is a third new code: 92025 Computerized corneal topography, unilateral or bilateral, with interpretation and report. Payment is inherently bilateral. This code can’t be reported pre- or postoperatively in conjunction with any of these four corneal transplant codes:

65710 Keratoplasty; lamellar
65730 penetrating (except in aphakia)
65750 penetrating (in aphakia)
65755 penetrating (in pseud- ophakia)


Work Values

The Academy was able to obtain an increase in physician work values for 12 CPT codes:

65426 Excision or transposition of pterygium; with graft
65850 Trabeculotomy ab externo
66761 Iridotomy/iridectomy by laser surgery (one or more sessions)
66821 Discission of secondary membra- nous cataract; laser surgery (e.g., YAG laser) (one or more sessions)
66984 Intracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique
67414 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression
67445 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with removal of bone for decompression
67500 Retrobulbar injection; medication
67505 Retrobulbar injection; alcohol
67904 Repair of blepharoptosis; (tarso) levator resection or advancement, external approach
67911 Correction of lid retraction
67966 Excision and repair eyelid; over one-fourth of lid margin

And the Academy successfully maintained values for eight other codes that had been under threat:

65420 Excision or transposition of pterygium; without graft
67840 Excision of lesion of eyelid (except chalazion) without clo- sure or with simple direct closure
68840 Probing of lacrimal canaliculi, with or without irrigation
76519 Ophthalmic biometry by ultra- sound echography, A-scan; with intraocular lens power calculation
92083 Visual field examination, unilat- eral or bilateral, with interpreta- tion and report; extended exami- nation
92226 Ophthalmoscopy, extended, with retinal drawing with interpreta- tion and report; subsequent
92235 Fluorescein angiography with interpretation and report
92250 Fundus photography with inter- pretation and report.

CPT 92025
CPT 92025 is one of three new codes.


Next month: Prevent costly coding errors.