By Cherie McNett, Academy Director of Health Policy, Michael Repka, MD, MBA, Academy Medical Director of Government Affairs, and Sue Vicchrilli, COT, OCS, Academy Director of Coding and Reimbursement
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The Current Procedural Terminology (CPT) codes are updated annually, with the addition of new codes and the revision or elimination of some old ones. In the listings below, “◉” is used to flag new codes and “▲” indicates that a code’s descriptor has been revised, with underlining and strikethroughs used to identify new and deleted language, respectively.
New Category I Code
There is a new Category I code to replace Category III code 0099T.
◉ 65785 Implantation of intrastromal corneal ring segment. This code has a 90-day global period. Two small intrastromal tunnels are created surgically, and intrastromal corneal implants are placed into each of the stromal incisions. The typical patient is a 27-year-old man with progressive keratoconus in both eyes who, even with glasses or contact lenses, can’t see well enough to do everyday tasks.
Trabeculoplasty Update
In 2000, CPT changed laser trabeculoplasty’s global period from 90 days to 10 days but did not change the descriptor. This year, the code’s descriptor was changed to reflect the fact that only 1 laser treatment is typically performed during the 10-day global period:
▲ 65855 Trabeculoplasty by laser surgery, 1 or more sessions (defined treatment series).
New instructions state that 65855 should not be submitted for payment in conjunction with any of the following CPT codes when performed in the same operative session:
65860 Severing adhesions of anterior segment, laser technique (separate procedure)
65865 Severing adhesions, goniosynechiae
65870 Severing adhesions anterior synechiae, except goniosynechiae
65875 Severing adhesions, posterior synechiae
65880 Severing corneovitreal adhesions
Retina Family Update
Several retina codes have been revised, and 1 retina code has been deleted.
▲ 67101 Repair of retinal detachment, 1 or more sessions; cryotherapy or diathermy, with or without including drainage of subretinal fluid, when performed
▲ 67105 photocoagulation, with or without including drainage of subretinal fluid, when performed
▲ 67107 Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), with or without including, when performed, implant, with or without cryotherapy, photocoagulation, and drainage of subretinal fluid
▲ 67108 with vitrectomy, any method, with or without including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique
▲ 67113 Repair of complex retinal detachment (e.g., proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, may include when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens
▲ 67227 Destruction of extensive or progressive retinopathy (e.g., diabetic retinopathy), 1 or more sessions cryotherapy, diathermy
▲ 67228 Treatment of extensive or progressive retinopathy, 1 or more sessions; (e.g., diabetic retinopathy), photocoagulation
The 2016 CPT book has eliminated 1 retina CPT code: 67112 Repair of retinal detachment; by scleral buckling or vitrectomy, on patient having previous ipsilateral retinal detachment repair(s) using scleral buckling or vitrectomy techniques. To report this procedure, see codes 67107, 67108, 67110, or 67113.