JUL 30, 2019
Complex Retina Repair without Membrane Peel
Question: Our surgeon performed a complex retinal detachment repair for a patient with proliferative vitreoretinopathy. The surgery included removal and replacement of silicone oil, scleral buckle, IOL repositioning and a laser. However, no membrane peel took place. Can we still submit CPT code 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, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens?
Answer: Since membrane peeling did not occur, the more appropriate code is 67108 Repair of retinal detachment; with vitrectomy, any method 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.
For the IOL repositioning, bill 66825 as the secondary procedure.
Learn more about procedures in the Complete Guide to Retina Coding.