• Billing Removal of Silicone Oil


    Question: For silicone oil removal by pars plana vitrectomy, can we bill CPT codes 67036 Vitrectomy, mechanical, pars plana approach and 67121 Removal of implanted material, posterior segment; intraocular? I feel 67121 is the most appropriate as a vitrectomy was previously performed. The doctor removed silicone oil due to complications.

    Answer: If the surgeon performs a PPV to remove the silicone oil, bill 67036; if aspiration technique, bill 67121. Do not submit both codes for the service; they are bundled in Correct Coding Initiative edits. Visit Coding Updates and Resources for the CMS CCI edits. CCI edits are also included in the Coding Coach: The Complete Ophthalmic Reference and the Retina Coding: Complete Reference Guide.